Pelvic Endometriosis - A Survey of Knowledge and Practice Among Gynecologists Endometriose Pélvica - Enquete com Médicos Ginecologistas

William Kondo, Paulo Afonso Monteiro Pacheco Guimarães, Viviane Margareth Scant Amburlo, Monica Tessmann Zomer
2012 · W2188779701
Observational OA: closed CC0 Metadata only
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A survey of 40 Brazilian gynecologists revealed varied knowledge and practice regarding endometriosis diagnosis, treatment, and surgical management, indicating a need for further education.

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Abstract

Purpose: Endometriosis affects a large number of reproductive age women. Clinical manifestations of the disease are cyclic pelvic pain and infertility. W omen with endometriosis usually seek medical advice from a gynecologist for their symptoms. The role of the gynecologist is therefore crucial in identifying, treating, and, when appropriatey, referring these patients promptly to specialised centers. Methods: A brief questionnaire was completed anonymously by 40 Brazilian gynecologists. Results: 67.5% of the respondents perform surgery for endometriosis. Approximately half (55%) of the respondents stated that the physical examination can diagnose cases of deeply infiltrating endometriosis; 92.5% do not exclude the possibility of deep endometriosis when serum CA-125 levels are normal. Magnetic resonance imaging, transvaginal ultrasound and colonoscopy are important in the preoperative assessment of the patient for 72.5%, 70%, and 62.5% of the respondents. For 62.5% of the respondents, GnRH analogues are the best medical management for endometriosis. Only 17.5% of the gynecologists think that all hormone-based treatments have similar outcomes. Although 80% of gynecologists responded that complete resection of the disease is the best treatment for deep lesions, 44% of the gynecologists that perform surgery for endometriosis recommend only diagnostic laparoscopy in these cases. Only 7.4% of the respondents are able to treat deep endometriosis with bowel involvement without the aid of a general surgeon or a colorectal surgeon. Conclusions: More education is required among gynecologists on the subject of endometriosis, in order to identify and treat patients with this disease. Referral to a center with the necessary expertise to offer all available treatments in a multi-disciplinary context is important to improve the surgical outcomes of deep infiltrating endometriosis.

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Condition tags

endometriosisdie_deep_infiltratinginfertility

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (34)

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