Audit on Diagnostic Modalities and Treatment of Endometriosis in a District General Hospital

Endometriosis affects approximately 10% of women of reproductive age, often resulting in chronic pelvic pain, infertility, and impaired quality of life.Despite its prevalence, delays in diagnosis remain a major challenge, frequently due to under-recognition of symptoms and the absence of standardized care pathways.National guidance from NICE and the recent NCEPOD report emphasise early recognition, appropriate imaging, and multidisciplinary care.This audit aimed to evaluate the diagnostic modalities and management of endometriosis at West Suffolk Hospital, assessing adherence to NICE NG73 guidelines and NCEPOD recommendations.A retrospective review was conducted of female patients aged 18 years and above who presented with symptoms suggestive of endometriosis between February and April 2024.Patients with prior diagnoses elsewhere were excluded.Data were collected using a tool based on NICE and NCEPOD standards.Eleven cases met inclusion criteria.Pelvic pain was the most frequent presenting symptom.All patients received analgesia and were offered hormonal therapy, consistent with NICE recommendations.Ten patients underwent ultrasound imaging, though only 36% received a transvaginal scan; average waiting time from referral to imaging was 1.3 months, with delays of up to 4 months in some cases.Only 9% of patients were referred to supportive services, while 27% had multidisciplinary team (MDT) involvement.Documentation of clinical examination was incomplete in 46% of cases.The audit highlighted alignment with medical management guidelines but revealed underuse of TVUS, variable documentation, and limited access to supportive services.Recommendations include strengthening MDT pathways, enhancing TVUS utilisation, and formalising a local care pathway.A re-audit is planned for October 2025.