Endometriosis is a common and often debilitating gynaecologic disease.
1
,2
In an effort to standardize treatment, the Society of Obstetricians and Gynaecologists
of Canada (SOGC) published updated clinical practice guidelines on the diagnosis and
management of endometriosis in 2010 (Table 1).
3
The objective of this study was to determine whether Canadian community physicians
adhered to national recommendations.
Table 1Summary of key findings compared with SOGC guidelines
| Management | Key findings | |
|---|---|---|
| Group 1 (2011–2012) | Group 2 (2015) | |
| Medical | ||
| First-line therapies include CHCs or progestins | 48% had tried at least 1 first-line agent | 61% had tried at least 1 first-line agent |
| Ideally, CHCs should be administered continuously | 27% prescribed CHCs were on continuous therapy | 32% prescribed CHCs were on continuous therapy |
| Second-line therapies include GnRH agonists and the LNG-IUS | 41% had tried second-line therapy | 43% had tried second-line therapy |
| Hormonal addback should be prescribed for patients on GnRH agonist therapy | 36% were on addback therapy with GnRH agonists | 54% were on addback therapy with GnRH agonists |
| Surgical | ||
| Surgery should be considered after failure of both first- and second-line medical therapy | 48% had not tried second-line medical therapy before surgery | 53% had not tried second-line medical therapy before surgery |
| Only surgeons who are capable of full resection should operate on endometriosis | 38% had incomplete surgery during their most recent excision/resection procedure | 20% had incomplete surgery during their most recent excision/resection procedure |
CHC: combined hormonal contraceptives; GnRH: gonadotropin-releasing hormone; LNG-IUS:
levonorgestrel intrauterine system; SOGC: Society of Obstetricians and Gynaecologists
of Canada.
a P ≤ 0.05, denoting significant differences between groups 1 and 2.
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References
- Diagnosis and treatment of endometriosis.Am Fam Phys. 1999; 60: 1753
- Endometriosis and mechanisms of pelvic pain.J Min Invas Gynecol. 2009; 16: 540-550
- Endometriosis: diagnosis and management.J Obstet Gynaecol Can. 2010 Jul; 32: S1-S32
Article info
Publication history
Published online: March 11, 2022
Identification
Copyright
© 2022 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
