Current practice for the laparoscopic diagnosis and treatment of endometriosis: a national questionnaire survey of consultant gynaecologists in UK

Moses, Sharon H; Clark, T. Justin

doi:10.1111/j.1471-0528.2004.00429.x

Cited by 15 publications

(9 citation statements)

References 20 publications

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“…Diagnostic laparoscopy is one of the most common surgical procedures performed by gynaecologists; in the United Kingdom, it was reported that 87% of consultant gynaecologists perform diagnostic laparoscopies, while only 41% include laparoscopic surgery in their routine practice. 9…”

Section: Discussionmentioning

confidence: 99%

Understanding pre-operative staging and surgical practice in advanced endometriosis: A survey of Canadian gynaecologists

Nica

Liu

Selk

et al. 2020

Journal of Endometriosis and Pelvic Pain Disorders

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Study objective: To determine the pre-operative evaluation, surgical management and referral practices in patients with advanced stage endometriosis by Canadian gynaecologists. Design: A survey of obstetricians and gynaecologists. Setting: The survey was initiated and piloted at an academic centre by general gynaecologists and endometriosis specialists. Intervention: Electronically distributed to 733 individuals by the Society of Obstetricians and Gynaecologists of Canada. This included all members, irrespective of subspecialty and practice patterns. Measurement: Responses were collected using a web-based survey tool and analysed using Excel. Results: The response rate was 15.7% (115 respondents). Pre-operatively, 62.2% of respondents perform a transvaginal ultrasound on all of their patients, while magnetic resonance imaging is reserved for patients with physical exam findings suspicious for advanced endometriosis (26.7%) or in whom the surgeons suspect deep infiltrating endometriosis, bowel, bladder or uterosacral disease (54.4%). Most surgeons (81.4%) report encountering advanced disease that they did not suspect pre-operatively <10% of the time. Although 40% of respondents would refer their patients in whom they suspected deep infiltrating endometriosis, endometriomas, bowel, bladder or uterosacral ligament involvement to an endometriosis specialist prior to any attempted surgery, 54.4% would never refer without previously confirming the diagnosis at laparoscopy. In contrast, only 15% felt comfortable treating advanced endometriosis completely at time of laparoscopy (including deep infiltrating endometriosis, bladder and bowel disease). Post-operatively, 67.8% of respondents refer patients to an endometriosis specialist only if their disease was not appropriately treated surgically, while 23.3% do not refer any of their patients. Conclusion: Our study identified significant variability in the management of advanced endometriosis in Canada. Understanding these patterns will help us formulate a more universal investigation and management plan, which may improve the identification of patients pre-operatively with advanced stage endometriosis that could benefit from treatment by an endometriosis specialist.

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Section: Discussionmentioning

confidence: 99%

Understanding pre-operative staging and surgical practice in advanced endometriosis: A survey of Canadian gynaecologists

Nica

Liu

Selk

et al. 2020

Journal of Endometriosis and Pelvic Pain Disorders

View full text Add to dashboard Cite

show abstract

“…The survey evaluated the surgical procedure, whether ablation or cauterization of the lesions was used. To our knowledge, this study is the first to evaluate gynecologists and their attitudes regarding symptoms of endometriosis and procedures involved in its diagnosis 13 . In general, gynecologists in this study suspected endometriosis and indicated a diagnostic procedure within one year for cases of Petta CA et al…”

Section: Attitudes and Practices Of Physicians In Relation To Endometmentioning

confidence: 99%

Current practice in the management of symptoms of endometriosis: a survey of Brazilian gynecologists

Petta¹,

Matos²,

Bahamondes³

et al. 2007

Rev. Assoc. Med. Bras.

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“…A survey of UK practice published in 2004 7 indicated that 85% of consultants regularly perform laparoscopic surgery for endometriosis. The vast majority use diathermy to ablate these deposits.…”

Section: Peritoneal Diseasementioning

confidence: 99%

Surgical management of endometriosis

Kenney

English

2007

The Obstetric & Gynaecologis

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Key content Advances in laparoscopic surgery have made the surgical management of endometriosis an effective treatment that offers advantages over medical therapy. The majority of gynaecologists readily perform laparoscopic ablation of superficial disease. Excision of deeper disease and management of rectovaginal disease require more expertise and should be managed in tertiary centres. Hysterectomy should not be necessary in the majority of cases. Although some women may benefit, extrauterine disease should also be excised. Evidence suggests that laparoscopic uterine nerve ablation (LUNA) has no effect on long‐term symptoms. There is no consensus as to the optimal surgical approach for rectal disease. A multicentre, randomised controlled trial is urgently required to resolve the issue. Learning objectives To understand the role of surgery in the management of endometriosis. To be aware of the best available evidence so that the optimal approach can be used when performing surgery. To be aware of the preoperative care of women with advanced disease and when to refer them for further management. Ethical issues What should be regarded as an acceptable complication rate for women undergoing surgery for advanced endometriosis? What level of training should gynaecologists reach if they are to be judged competent in the surgical management of endometriosis? Given that the surgical management of endometriosis is a developing skill, where is the boundary between accepted and acceptable practice? Please cite this article as: Kenney N, English J. Surgical management of endometriosis. The Obstetrician & Gynaecologist 2007;9:147–152.

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Current practice for the laparoscopic diagnosis and treatment of endometriosis: a national questionnaire survey of consultant gynaecologists in UK

Cited by 15 publications

References 20 publications

Understanding pre-operative staging and surgical practice in advanced endometriosis: A survey of Canadian gynaecologists

Understanding pre-operative staging and surgical practice in advanced endometriosis: A survey of Canadian gynaecologists

Current practice in the management of symptoms of endometriosis: a survey of Brazilian gynecologists

Surgical management of endometriosis

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