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Review
. 2006 Nov;52(11):1420-4.

Managing the misplaced: approach to endometriosis

Bethany Jackson  1 , Deanna E Telner
Affiliations
Review

Managing the misplaced: approach to endometriosis

Bethany Jackson et al. Can Fam Physician. 2006 Nov.

Abstract
in English, French

Objective: To review the presentation of endometriosis, steps to diagnosis, and medical and surgical management options.

Sources of information: MEDLINE was searched from January 1996 to November 2004, EMBASE from January 1996 to January 2005, and the Cochrane Database of Systematic Reviews for the 4th quarter of 2004.

Main message: Endometriosis is a common, progressive disease with an estimated prevalence of 10%. It can cause dyspareunia, dysmenorrhea, low back pain, and infertility. It can be diagnosed on clinical grounds and treated without laparoscopy provided pregnancy is not desired. First- and second-line medical treatments are nonsteroidal anti-inflammatory drugs, combined oral contraceptive pills, progestins, gonadotropin-releasing hormone agonists, and androgens. Surgical options should be considered when these medications are ineffective or if pregnancy is desired.

Conclusion: Family physicians have an important role in diagnosing and treating women with endometriosis.

OBJECTIF: Faire le point sur les manifestations cliniques de l’endométriose, les étapes du diagnostic et les options de traitement par médication et chirurgical.

SOURCES DE L’INFORMATION: On a consulté MEDLINE de janvier 1996 à novembre 2004, EMBASE de janvier 1996 à janvier 2005 et la base de données Cochrane sur les revues systématiques du quatrième trimestre de 2004.

PRINCIPAL MESSAGE: L’endométriose est une maladie progressive fréquente; sa prévalence est estimée à 10 %. Elle peut être responsable de dyspareunie, de dysménorrhée, de douleurs lombaires et d’infertilité. Elle peut être diagnostiquée cliniquement et traitée sans laparoscopie, à condition qu’on n’envisage pas de grossesse. Le traitement par médication de première et de deuxième intention inclut les anti-inflammatoires non stéroïdiens, les anticonceptionnels oraux combinés, les progestatifs, les agonistes de la gonadolibérine et les androgènes. La chirurgie devrait être envisagée lorsque ces médicaments sont inefficaces ou si une grossesse est désirée.

CONCLUSION: Le médecin de famille a un rôle important à jouer dans le diagnostic et le traitement des femmes atteintes d’endométriose.

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References

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