Pelvic endometriosis: Refer to the surgeon at the right moment: Pelvic endometriosis: When refer to the surgeon?

Marie Pécout, Pécout M, Jean Dit Gautier E, Estelle Jean Dit Gautier, Guillaume Doucède, Doucède G, Pierre Collinet, Collinet P, Rubod C, Chrystèle Rubod
Journal of gynecology obstetrics and human reproduction · 2020 · vol. 49(4) , pp. 101701 · doi:10.1016/j.jogoh.2020.101701 · PMID:32028037 · W3004632946
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This paper discusses the appropriate timing for surgical referral in patients diagnosed with pelvic endometriosis.

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Abstract

BACKGROUND: As endometriosis is not a single condition but different morphological types, it is easy to conceive that its management allow for a diversity of approaches. The objective of this literature review is about a simplified pathway through care for patients with endometriosis, and to target the right time for surgical treatment. METHODS: Through a literature and references review, the different surgical care arrangements according to attainment, to symptoms and to the patients demands and expectations are reviewed. RESULTS: An existing literature and recommendations synthesis has been done, and it was found that an optimum medical or surgical care rely on a multidisciplinary approach. Asymptomatic patients should not have surgery, and the medical treatment precede surgical treatment in numerous indications. In case of a surgical need, the right moment is determined by the recommendations, as noted in this article. Different aspects are necessary, the symptomatology, the intend to be pregnant and the recurrence of lesions in particular, but also the use of medically assisted reproduction or not. CONCLUSION: In order to optimize the surgical treatment of patients with endometriosis, it is advisable to not refer these patients to the surgeon not too soon and not too late, furthermore if he's an expert. In all cases the treatment is multidisciplinary, and the most difficult cases are referred to multidisciplinary consultative reunion. The surgical treatment relies on "centre of expertise's" existence for some specific forms of deep endometriosis. The surgical treatment is a question of both pathology and timing. BRIEF SUMMARY: In order to optimize the surgical treatment of endometriosis, it is advisable to refer patients to the surgeon at the right moment.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gynecologic Surgical Procedures Gynecologic Surgical Procedures Referral and Consultation Referral and Consultation Clinical Competence Clinical Competence Endometriosis Endometriosis Endometriosis Endometriosis Female Female Fertility Preservation Fertility Preservation Humans Humans Infertility, Female Infertility, Female Interdisciplinary Communication

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (58)

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License: CC0 · commercial use OK