Diagnosis and management of endometriosis: The role of the advanced practice nurse in primary care

Abstract

To obtain CE credit for this activity, go to www.aanp.org and click on the CE Center. Locate the listing for this article and complete the post-test. Follow the instructions to print your CE certificate. AbstractPurpose: To discuss the etiology, clinical presentation, diagnosis, and management of endometriosis for the advanced practice nurse (APN) in primary care.Data sources: Selected research, clinical studies, clinical practice guidelines, and review articles. Conclusions:Commonly encountered by the APN in primary care, endometriosis is a chronic, progressive inflammatory disease characterized by endometrial lesions, cysts, fibrosis, or adhesions in the pelvic cavity, causing chronic pelvic pain and infertility in women of reproductive age. Because of its frequently normal physical examination findings, variable clinical presentations, and nonspecific, overlapping symptoms with other conditions, endometriosis can be difficult to diagnose. As there currently are no accurate noninvasive diagnostic tests specific for endometriosis, it is imperative for the APN to become knowledgeable about the etiology, clinical presentation, diagnosis, and current treatment options of this disease. Implications for practice:The APN in primary care plays an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. APNs can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease. Practice recommendations include timely diagnosis, pain management, infertility counseling, patient education, and support for quality of life issues.

Functional Connectivity Is Associated With Altered Brain Chemistry in Women With Endometriosis-Associated Chronic Pelvic Pain

“…21, 43, 45, 62, 68 Endometriosis is defined as the presence of endometrial glands and stroma (referred to as “endometriosis implants”) outside of the uterus. Thus it is a histological diagnosis that requires surgical evaluation and biopsy.…”

Effect of an Educational Intervention on Quality of Life and Sexual Function in Women with Endometriosis

“…Nurses play an essential role in health promotion through disease management and infertility prevention by providing support and required information to the woman with endometriosis. Nurses can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease (Mao and Anastasi, 2010). In addition, the nurse should allow time for the woman to express concerns about complaints and treatment modalities.…”

Coping strategies employed by women with endometriosis in a public health-care setting

“…The primary symptom indicating endometriosis is chronic pelvic pain. Other symptoms include dysmenorrhoea, sub-fertility, ovarian cysts and dyspareunia (painful sexual intercourse) (Mao and Anastasi, 2010; Sinaii et al, 2008). Pain experienced by patients is cyclical with periods of pain and relief based on the patient’s menstrual cycle (Denny, 2004).…”