Standards Used by a Clinical and Scientific Endometriosis Center for the Diagnosis and Therapy of Patients with Endometriosis

Abstract

Endometriosis is one of the most common benign gynecological diseases. The extremely heterogeneous complex of symptoms complicates the diagnosis and treatment of this disease. In most patients, there is a latency period of several years between the first occurrence of symptoms and the definitive diagnosis. This paper aims (1) to evaluate standards for the diagnosis and treatment of patients with (symptoms suspicious for) endometriosis in terms of feasibility, and (2) to assess the potential use of data collected by a certified clinical and scientific endometriosis center to answer scientific questions. Standards for outpatient consultations were developed for a special endometriosis outpatient clinic. Between January 2014 and December 2017, a total of 1715 outpatients with a suspicion of endometriosis presented to this special endometriosis outpatient clinic; the diagnosis and treatment of patients was carried out in accordance with the developed standards. Data of this patient cohort obtained from patient records created during outpatient consultations and from a questionnaire recorded in an Oracle-based database was analyzed. The patient cohort was also compared with another patient cohort who had attended different outpatient clinics and had been diagnosed intraoperatively with endometriosis. 41.8% of patients examined during special outpatient consultations had surgery for suspicion or recurrence of endometriosis. Endometriosis was confirmed in 81.5% of cases. Pain symptoms were the main indication for surgery in 70.1% of cases compared to 45.1% of cases in the comparison group. The structured approach used in the special endometriosis outpatient clinic is a key aspect of the care provided by the certified clinical and scientific endometriosis center. It ensures that patients are diagnosed and treated in accordance with guideline recommendations, that diagnosis and treatment comply with certification requirements, and that the collected data can be used to answer scientific questions.

QS ENDO Real – A Study by the German Endometriosis Research Foundation (SEF) on the Reality of Care for Patients with Endometriosis in Germany, Austria and Switzerland

“…This means that a survey investigating the quality of results cannot be effectively implemented [18]. A first retrospective analysis showed that a diagnostic and treatment concept based on the main presenting symptom was introduced as a single center concept in a special outpatient clinic for endometriosis and that this made it possible to provide a guideline-based diagnosis and treatment [19]. The aim of the QS ENDO survey is to identify indicators which can be used to measure the quality of treatment.…”

Cycle-related Diarrhea and Dysmenorrhea are Independent Predictors of Peritoneal Endometriosis, Cycle-related Dyschezia is an Independent Predictor of Rectal Involvement

“…The heterogeneity of endometriosis symptoms delays the diagnosis and makes obtaining a correct diagnosis more difficult [28]. rASRM scores are not correlated with patientsʼ symptoms.…”

Does Nutrition Affect Endometriosis?

“…Endometriosis is a hormone-related, chronic inflammation in women. Approximately 27 000 women were treated in hospital for endometriosis in Germany in 2016 1 . The prevalence is much higher, however, affecting between 5 and 15% of women of childbearing age 2 .…”

“…Im Jahr 2016 wurden in Deutschland ca. 27 000 Patientinnen aufgrund einer Endometriose stationär behandelt 1 . Die Prävalenz liegt deutlich höher und beträgt ca.…”