Without an animal model and a non-invasive diagnosis, the
pathophysiology of endometriosis is unclear and information is limited
to symptomatic women. Lesions are biochemically variable. Medical
therapy cannot be blinded and extensive surgery combines low numbers
with variable difficulty and surgical skills. Experience is spread among
specialists in imaging, medical therapy, infertility, pain and surgery.
Besides the recent changes in interpreting statistical analyses, the
limited good-quality evidence increases the importance of clinical
experience. Therefore trial design, analysis and judgment of results
should be done by experts in the different disciplines of endometriosis,
before being translated into guidelines.