Signes spécifiques cliniques évocateurs de l’endométriose (hors adénomyose) et questionnaires de symptômes, de douleur et qualité de vie, RPC Endométriose CNGOF-HAS

Huchon, Cyrille; Aubry, Gabrielle; Ploteau, Stéphane

doi:10.1016/j.gofs.2018.02.022

Cited by 5 publications

(5 citation statements)

References 97 publications

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“…Getting rid of my reproductive organs has been hands down the best most liberating decision of my life." (Confirmed,(25)(26)(27)(28)(29)(30)Nulliparous) . /fgwh.…”

Section: Hysterectomymentioning

confidence: 84%

“…Symptom histories are where patients share with their doctors the occurrence, prevalence and degree of the endometriosis symptoms they experience. The purpose of physical exams of endometriosis patients is to assess whether bluish lesions can be identified in the vagina, to palpate the nodules in the uterosacral ligaments or pouch of Douglas, to assess if there is pain when applying tension to the uterosacral ligaments and to determine whether the uterus is retroverted ( 30 ). However, these types of physical assessments have highly variable sensitivity and specificity for the diagnosis of endometriosis, even when carried out in expert centers ( 30 ).…”

Section: Resultsmentioning

confidence: 99%

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The experiences of endometriosis patients with diagnosis and treatment in New Zealand

Ellis

Munro

Wood

2022

Front. Glob. Womens Health

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Endometriosis is a chronically painful, invasive, inflammatory disease, with limited treatment options and long delays to diagnosis, which impacts 10% of females in New Zealand.IntroductionAs part of a larger group discussion study, this paper covers three themes associated with endometriosis patient experiences: intensity of pain, diagnostic tool shortcomings and perspectives of treatment options.Materials and methodsThe goal of this research was the inclusion of patient voices to guide research priorities. In early 2022, 50 New Zealand endometriosis patients participated in anonymous, asynchronous, text-based group discussions on the VisionsLive platform. The patients ranged in age from 18–48. The patients answered 50 questions, 23 text-based and 27 quantitative, and then took part in online group discussions.Results and discussionThe average age of symptom onset was 15.3 years, while the average delay from symptom onset to a working or surgically confirmed diagnosis was 7.91 years. The top five reported symptoms within the cohort were pain-based, and the participants discussed the many impacts of this pain on their work and education. The four main diagnostic tools employed on this cohort were abdominal ultrasound (72%), transvaginal ultrasound (68%), laparoscopy (82%) and sharing their symptom history with a medical practitioner (88%). The most common emotions patients experienced following receiving a diagnosis of endometriosis were relief (86%), feeling overwhelmed (54%), and anger (32%). The main treatments offered to this cohort were pain relief (96%), laparoscopic surgery (84%) and the combined oral contraceptive pill (80%). Of these three treatments, only laparoscopic surgery was viewed positively by the majority of users, with 67% considering laparoscopy an effective treatment, compared to 46% of users for pain relief, and 25% of users for the combined oral contraceptive pill.ConclusionsGathering the voice of patients revealed that long delays to diagnosis and dismissal by medical practitioners frequently manifests as a reaction of relief by patients once diagnosed. Results also showed treatment options such as pain relief and hormonal medications were often considered ineffective, but were routinely offered as the first, or only, options for patients. It is therefore important that both quicker routes to diagnosis and more effective treatment options be developed.

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“…Getting rid of my reproductive organs has been hands down the best most liberating decision of my life." (Confirmed,(25)(26)(27)(28)(29)(30)Nulliparous) . /fgwh.…”

Section: Hysterectomymentioning

confidence: 84%

Section: Resultsmentioning

confidence: 99%

The experiences of endometriosis patients with diagnosis and treatment in New Zealand

Ellis

Munro

Wood

2022

Front. Glob. Womens Health

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“…The pain symptoms associated with endometriosis vary between patients [3]. The main symptoms suggestive of endometriosis and its location are: severe dysmenorrhoea (a pain intensity score of 8 or more on a 10-point scale, frequently missing school or work, or resistance to step 1 analgesics) (LoE2), deep dyspareunia (LoE2), pain on defecation with menstruation (LoE2), urinary symptoms with menstruation (LoE2), and infertility (LoE2) [3,9]. Note that pain symptoms such as severe dysmenorrhoea and deep dyspareunia are common in the general population (LoE3) and are not necessarily due to endometriosis (LoE3).…”

Section: Endometriosis-related Painmentioning

confidence: 99%

“…The chronic pain experienced by women with endometriosis can have a major physical, mental and social impact (LoE4). Pain thresholds can be altered in endometriosis, resulting in pain that appears disproportionate to the lesions observed (sensitization) (LoE2) [3].…”

Section: Endometriosis-related Painmentioning

confidence: 99%

“…Signs suggestive of endometriosis are: bluish lesions observed during examination with a vaginal speculum, palpable nodules in the uterosacral ligaments or posterior cul-de-sac, uterosacral ligament tenderness, a retroverted uterus, or fixation of the adnexa on bimanual pelvic examination (LoE3) [3].…”

Section: Physical Examination and Signs Suggestive Of Endometriosismentioning

confidence: 99%

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Management of endometriosis

Collinet

Fritel

Revel-Delhom

et al. 2018

Journal of Gynecology Obstetrics and Human Reproduction

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First-line diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The second-line investigations are: targeted pelvic examination performed by an expert clinician, transvaginal ultrasound performed by an expert physician sonographer (radiologist or gynaecologist), and pelvic MRI. Management of endometriosis is recommended when the disease has a functional impact. Recommended first-line hormonal therapies for the management of endometriosis-related pain are combined hormonal contraceptives (CHCs) or the 52mg levonorgestrel-releasing intrauterine system (IUS). There is no evidence base on which to recommend systematic preoperative hormonal therapy solely to prevent surgical complications or facilitate surgery. After surgery for endometriosis, a CHC or 52mg levonorgestrel-releasing IUS is recommended as first-line treatment when pregnancy is not desired. In the event of failure of the initial treatment, recurrence, or multiorgan involvement, a multidisciplinary team meeting is recommended, involving physicians, surgeons and other professionals. A laparoscopic approach is recommended for surgical treatment of endometriosis. HRT can be offered to postmenopausal women who have undergone surgical treatment for endometriosis. Antigonadotrophic hormonal therapy is not recommended for patients with endometriosis and infertility to increase the chances of spontaneous pregnancy, including postoperatively. Fertility preservation options must be discussed with patients undergoing surgery for ovarian endometriomas.

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

Collinet

Fritel

Revel-Delhom

et al. 2018

Gynécologie Obstétrique Fertilité & Sénologie

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Signes spécifiques cliniques évocateurs de l’endométriose (hors adénomyose) et questionnaires de symptômes, de douleur et qualité de vie, RPC Endométriose CNGOF-HAS

Cited by 5 publications

References 97 publications

The experiences of endometriosis patients with diagnosis and treatment in New Zealand

The experiences of endometriosis patients with diagnosis and treatment in New Zealand

Management of endometriosis

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

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