Prise en charge de l’endométriose : recommandations pour la pratique clinique CNGOF-HAS (texte court)

Pierre Collinet, Collinet P, P Collinet, Xavier Fritel, X Fritel, Revel-Delhom C, C. Revel-Delhom, Ballester M, M Ballester, Marcos Ballester, Bolze PA, Pierre‐Adrien Bolze, P A Bolze, B Borghese, Bruno Borghese, Bornsztein N, N. Bornsztein, Boujenah J, J. Boujenah, Nicolas Bourdel, N Bourdel, Bourdel N, Brillac T, Thierry Brillac, T Brillac, Chabbert-Buffet N, N Chabbert-Buffet, Nathalie Chabbert‐Buffet, C Chauffour, Chauffour C, Nathalie Clary, Clary N, N Clary, Jonathan Cohen, Cohen J, J. Cohen, C Decanter, Decanter C, Christine Decanter, Amélie Denouël, A Denouël, Denouël A, G Dubernard, Gil Dubernard, Dubernard G, Fauconnier A, A Fauconnier, Arnaud Fauconnier, H. Fernandez, Gauthier T, T Gauthier, Golfier F, F. Golfier, François Golfier, Cyrille Huchon, Huchon C, C Huchon, Legendre G, Guillaume Legendre, G Legendre, J. Loriau, Loriau J, Mathieu-d'Argent E, Emmanuelle Mathieu-D’Argent, E Mathieu-d'Argent, B Merlot, Merlot B, Benjamin Merlot, Niro J, J. Niro, Panel P, P. Panel, P. Paparel, Paparel P, C A Philip, Charles‐André Philip, Ploteau S, Stéphane Ploteau, S Ploteau, C. Poncelet, Poncelet C, Rabischong B, B. Rabischong, Horace Roman, Roman H, H. Roman, Chrystèle Rubod, Rubod C, C. Rubod, Santulli P, Piétro Santulli, P Santulli, Sauvan M, M. Sauvan, Isabelle Thomassin‐Naggara, Thomassin-Naggara I, I Thomassin-Naggara, Antoine Torre, Torre A, A Torre, Wattier JM, Jean‐Michel Wattier, J M Wattier, Chadi Yazbeck, C Yazbeck, M Canis, Michel Canis
Gynecologie, obstetrique, fertilite & senologie · 2018 · vol. 46(3) , pp. 144–155 · doi:10.1016/j.gofs.2018.02.027 · PMID:29550339 · W2791588602
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This paper provides clinical practice recommendations for the management of endometriosis, developed by the CNGOF-HAS.

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Abstract

First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent echographist, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined with hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery. After endometriosis surgery, combined hormonal contraceptives or levonorgestrel SIU 52mg are recommended as first-line therapy in the absence of desire of pregnancy. In case of initial treatment failure, recurrence, or multiple organ involvement by endometriosis, medico-surgical and multidisciplinary discussion is recommended. The laparoscopic approach is recommended for the surgical treatment of endometriosis. HRT may be offered in postmenopausal women operated for endometriosis. In case of infertility related to endometriosis, it is not recommended to prescribe anti-gonadotropic hormone therapy to increase the rate of spontaneous pregnancy, including postoperatively. The possibilities of fertility preservation should be discussed with the patient in case of surgery for ovarian endometrioma.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Complementary Therapies Contraceptives, Oral, Hormonal Diagnostic Imaging Endometriosis Female Gynecological Examination Humans Infertility, Female Infertility, Female Infertility, Female Patient Education as Topic Pelvic Pain Pelvic Pain Pelvic Pain

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