REVIEW  INNOVATIONS IN GYNECOLOGY AND OBSTETRICS 

Minerva Ginecologica 2019 February;71(1):54-61

DOI: 10.23736/S0026-4784.18.04320-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Management of endometriosis from diagnosis to treatment: roadmap for the future

Ludovico MUZII ✉, Chiara DI TUCCI, Mara DI FELICIANTONIO, Giulia GALATI, Claudia MARCHETTI, Giorgia PERNIOLA, Francesco PECORINI, Pierluigi BENEDETTI PANICI

Department of Obstetrics and Gynecology, Sapienza University, Rome, Italy

Endometriosis, in spite of decades of research on the topic, remains a mysterious and elusive disease. Both in the fields of diagnosis and treatment, many issues remain unresolved, and the scientific community strives in trying to find universal criteria for diagnosis, and algorithms of treatment that may be universally applied. Recently, there has been a shift away from the view of the need of invasive diagnosis and therapy with the universal use of laparoscopy. Today the diagnosis of endometriosis may be reliably performed with noninvasive methods, and therapy can be nonsurgical in most cases. Recent guidelines state that diagnostic laparoscopy may be better seen as a second line of investigation, whereas medical therapy with either oral estroprogestins or progestogens is the first therapeutic option in case of associated pain. A thorough discussion with the patient should address all the available treatments, so as to make a shared decision on which treatment best fits the needs of that single patient.

KEY WORDS: Endometriosis - Therapeutics - Diagnosis - Laparoscopy