Guidelines of the Polish Society of Gynecologists and Obstetricians on the management of women with endometriosis

This paper presents Polish Society of Gynecologists and Obstetricians clinical guidelines for diagnosing and managing endometriosis and adenomyosis, outlining high-level recommendations for clinical evaluation, imaging (including transvaginal ultrasound and protocol-based MRI in deep disease), and the role of questionnaires and ancillary tests, with the caveat that negative imaging does not exclude superficial lesions. For endometriosis, it recommends long-term pharmacotherapy with combined oral contraceptives (preferably including dienogest) or progestogen alternatives when estrogens are contraindicated, generally discourages preoperative hormonal suppression for surgical visualization, and emphasizes careful surgical strategies to protect ovarian reserve and confirm pathology. The guideline sections on infertility state that ovulation-suppressing preoperative pharmacotherapy does not improve conception chances and outline when surgery or assisted reproduction may be considered, while also noting that postoperative hormone therapy after fertility-focused treatment is not recommended solely to improve fertility. It also provides an adenomyosis diagnostic algorithm (clinical data, exam, MUSA ultrasound, and hysteroscopy or MRI when uncertain) and discusses treatment options by reproductive goals. This paper is centrally about endometriosis — it provides comprehensive Polish management guidelines covering diagnosis, therapy, surgery, and infertility/adjunct care, with an additional dedicated section on adenomyosis.

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