Multidisciplinary approach for deep endometriosis: Interests and organization [Réunion de concertation pluridisciplinaire de l'endométriose pelvienne profonde : intérêts et modalités de fonctionnement]

摘要

Deep endometriosis is a frequent disease that affects reproductive age women. This disease is characterized by the presence of functional endometrium-like tissue outside the uterus. The common sites of extragenital endometriosis are the bowel and the urinary tract. This disease is also associated with infertility. Furthermore, this disease can cause physical and psychological damage. Therefore, it is really important to develop a multidisciplinary approach in the aim to offer the appropriate treatment. The multidisciplinary team approach for endometriosis is developing to improve the understanding of endometriosis and a multidiciplinary committee for endometriosis was developed in our center. During this meeting, gynecologic, digestive surgeons, urologist, radiologist, procreative medical assistance physicians analyse the case. The role of surgery, before, after or as an alternative to in vitro fertilization (IVF) must be defined. The role of the medical treatment before or after the surgery, before the IVF shall be discussed in order to propose the optimal treatment. In fact, radical surgery is no more recommanded and minimaly invasive conservative surgery is encouraged in order to preserve the fertility. The multidisciplinary appraoach permits an appropriate optimal and personalised management of this multifocal disease. The multidisciplinary team approach helps in the developpement of evidence-based guidelines for the diagnosis and management of endometriosis.