Diagnosis and management of endometriosis: the role of the advanced practice nurse in primary care.
OBJECTIVE
To discuss the etiology, clinical presentation, diagnosis, and management of endometriosis for the advanced practice nurse (APN) in primary care.


METHODS
Selected research, clinical studies, clinical practice guidelines, and review articles.


CONCLUSIONS
Commonly encountered by the APN in primary care, endometriosis is a chronic, progressive inflammatory disease characterized by endometrial lesions, cysts, fibrosis, or adhesions in the pelvic cavity, causing chronic pelvic pain and infertility in women of reproductive age. Because of its frequently normal physical examination findings, variable clinical presentations, and nonspecific, overlapping symptoms with other conditions, endometriosis can be difficult to diagnose. As there currently are no accurate noninvasive diagnostic tests specific for endometriosis, it is imperative for the APN to become knowledgeable about the etiology, clinical presentation, diagnosis, and current treatment options of this disease.


CONCLUSIONS
The APN in primary care plays an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. APNs can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease. Practice recommendations include timely diagnosis, pain management, infertility counseling, patient education, and support for quality of life issues.
Mao
Alexandra J
AJ
Columbia University School of Nursing, New York, New York 10032, USA. ajm2111@columbia.edu
Anastasi
Joyce K
JK
D057179:Advanced Practice Nursing / Q000458:organization & administration*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D019468:Disease Management; D004715:Endometriosis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D005260:Female; D006293:Health Promotion; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control; D008487:Medical History Taking; D024802:Nurse's Role; D010353:Patient Education as Topic; D017699:Pelvic Pain / Q000209:etiology / Q000517:prevention & control; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D017009:Professional Autonomy; D012720:Severity of Illness Index; D012944:Social Support