Consensus-based management of endometriosis-associated pelvic pain: Results of a French Delphi study

OBJECTIVE: To develop best practice guidelines under the auspices of the CNGOF (National college of French Gynaecologist Obstetrician) and Convergences PP (Convergences in Pelviperineal Pain) for the management of endometriosis-associated pelvic pain. METHOD: We organised a literature review and a formal group consensus. A multidisciplinary steering committee composed of 14 healthcare professionals and 2 patients association representatives drafted an argument based on literature analysis, resulting in 7 proposed definitions and 59 best practice recommendations. These proposals were then submitted for review by 108 French healthcare professionals from various specialties and professions. The first two rounds of rating were conducted online between June 2024 and November 2024, followed by a final videoconference meeting in January 2025. RESULTS: The participation rate was 68% in the first round (74/108) and 76% in the second round (56/74). In total, 3 definitions and 45 best practice recommendations were retained and distributed across 6 sections: 1) Definition; 2) Assessment of chronic pelvic pain associated with endometriosis; 3) Non-pharmacological management; 4) Pharmacological management; 5) Surgical management; 6) Communication, health education, and therapeutic education. CONCLUSION: This formal consensus process has enabled the development of definitions and best practice guidelines to assist healthcare professionals in managing patients suffering from pain associated with endometriosis, thereby promoting better screening, characterization of pain, and therapeutic management.