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SOGC CLINICAL PRACTICE GUIDELINE| Volume 32, ISSUE 7, SUPPLEMENT 2, S1-S3, July 2010

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Endometriosis: Diagnosis and Management

DOI:https://doi.org/10.1016/S1701-2163(16)34589-3
Endometriosis: Diagnosis and Management
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      Abstract

      Objective

      To improve the understanding of endometriosis and to provide evidence-based guidelines for the diagnosis and management of endometriosis.

      Outcomes

      Outcomes evaluated include the impact of the medical and surgical management of endometriosis on women’s experience of morbidity and infertility.

      Methods

      Members of the guideline committee were selected on the basis of individual expertise to represent a range of practical and academic experience in terms of both location in Canada and type of practice, as well as subspecialty expertise along with general gynaecology background. The committee reviewed all available evidence in the English and French medical literature and available data from a survey of Canadian women. Recommendations were established as consensus statements. The final document was reviewed and approved by the Executive and Council of the SOGC.

      Results

      This document provides a summary of up-to-date evidence regarding diagnosis, investigations, and medical and surgical management of endometriosis. The resulting recommendations may be adapted by individual health care workers when serving women with this condition.

      Conclusions

      Endometriosis is a common and sometimes debilitating condition for women of reproductive age. A multidisciplinary approach involving a combination of lifestyle modifications, medications, and allied health services should be used to limit the impact of this condition on activities of daily living and fertility. In some circumstances surgery is required to confirm the diagnosis and provide therapy to achieve the desired goal of pain relief or improved fecundity. Women who find an acceptable management strategy for this condition may have an improved quality of life or attain their goal of successful pregnancy.

      Evidence

      Medline and Cochrane databases were searched for articles in English and French on subjects related to endometriosis, pelvic pain, and infertility from January 1999 to October 2009 in order to prepare a Canadian consensus guideline on the management of endometriosis.

      Values

      The quality of evidence was rated with use of the criteria described by the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described by the Task Force. See Table 1.

      Benefits, harms, and costs

      Implementation of the guideline recommendations will improve the care of women with pain and infertility associated with endometriosis.

      Key Words

      Article info

      Footnotes

      This Clinical Practice Guideline has been reviewed by the Clinical Practice Gynaecology Committee and reviewed and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada

      Disclosure statements have been received from all members of the committee.

      The literature searches and bibliographic support for this guideline were undertaken by Becky Skidmore, Medical Research Analyst, Society of Obstetricians and Gynaecologists of Canada.

      This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the SOGC

      Identification

      DOI: https://doi.org/10.1016/S1701-2163(16)34589-3

      Copyright

      © 2010 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

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