Traitement médical de l’endométriose

Résumé L’endométriose est une affection fréquente dont les symptômes peuvent être variés. Le traitement curatif repose surtout sur l’approche opératoire, mais le traitement médical prend une place croissante dans la préparation à la chirurgie et surtout dans la prévention des récidives. La base du traitement est l’hormonothérapie dont l’objectif est d’obtenir une hypo-oestrogénie. Si les agonistes de la GnRH sont prescrits de façon limitée dans le temps, les pilules oestroprogestatives et les progestatifs pourront être administrés beaucoup plus longtemps. Abstract Endometriosis is a common condition with various symptoms. The curative treatment is usually associated to surgical approach. The aim of medical treatment is to avoid recurrences and, in association to surgery, offer the patient a limited and less aggressive approach. GnRH agonists can be used for limited duration. Progestatives can be administered for a longer period to prevent recurrences. Références Guo SW (2009) Recurrence of endometriosis and its control. Hum Reprod Update 15:441–61 Vercellini P, Somigliana E, Vigano P, et al (2009) The effect of second-line surgery on reproductive performance of women with recurrent endometriosis: a systematic review. Acta Obstet Gynecol Scand 88:1074–82 Koga K, Osuga Y, Takemura Y, et al (2013) Recurrence of endometrioma after laparoscopic excision and its prevention by medical management. Front Biosci (Elite Ed) 5:676–83 Somigliana E, Vercellini P, Vigano P, et al (2014) Postoperative medical therapy after surgical treatment of endometriosis: from adjuvant therapy to tertiary prevention. J Minim Invasive Gynecol 21:328–34 Vercellini P, Frontino G, De Giorgi O, et al (2003) Continuous use of an oral contraceptive for endometriosis-associated recurrent dysmenorrhea that does not respond to a cyclic pill regimen. Fertil Steril 80:560–3 Seracchioli R, Mabrouk M, Manuzzi L, et al (2009) Postoperative use of oral contraceptive pills for prevention of anatomical relapse or symptom-recurrence after conservative surgery for endometriosis. Hum Reprod 24:2729–35 Roman H (2007) [Guidelines for the management of painful endometriosis]. J Gynecol Obstet Biol Reprod (Paris) 36:141–50 Donnez J, Nisolle M, Grandjean P, et al (1992) The place of GnRH agonists in the treatment of endometriosis and fibroids by advanced endoscopic techniques. Br J Obstet Gynaecol 99 (Suppl 7):31–3 Redwine DB (1991) Conservative laparoscopic excision of endometriosis by sharp dissection: life table analysis of reoperation and persistent or recurrent disease. Fertil Steril 56:628–34 Dubernard G, Piketty M, Rouzier R, et al (2006) Quality of life after laparoscopic colorectal resection for endometriosis. Hum Reprod 21:1243–7 Jones KD, Haines P, Sutton CJ (2001) Long-term follow-up of a controlled trial of laser laparoscopy for pelvic pain. JSLS 5:111–5 Giudice LC (2010) Clinical practice. Endometriosis. N Engl J Med 362:2389–98 Angioni S, Pontis A, Dessole M, et al (2015) Pain control and quality of life after laparoscopic en-block resection of deep infiltrating endometriosis (DIE) vs. incomplete surgical treatment with or without GnRHa administration after surgery. Arch Gynecol Obstet 291:363–70 Vercellini P, Crosignani PG, Abbiati A, et al (2009) The effect of surgery for symptomatic endometriosis: the other side of the story. Hum Reprod Update 15:177–88 Roman H, Vassilieff M, Gourcerol G, et al (2011) Surgical management of deep infiltrating endometriosis of the rectum: pleading for a symptom-guided approach. Hum Reprod 26:274–81 Somigliana E, Vercellini P, Daguati R, et al (2010) Effect of delaying post-operative conception after conservative surgery for endometriosis. Reprod Biomed Online 20:410–5 Author information Authors and Affiliations Corresponding author About this article Cite this article Ploteau, S. Traitement médical de l’endométriose. Colon Rectum 10, 164–166 (2016). https://doi.org/10.1007/s11725-016-0660-4 Published: Issue date: DOI: https://doi.org/10.1007/s11725-016-0660-4