[Endometriosis and chronic pelvic pain].
OBJECTIVE
To analyse pathophysiology and clinical symptoms of chronic pelvic pain and their therapeutic care.


METHODS
Review of articles and consensus conferences published on this subject in the Medline(®) (PubMed(®)) database.


RESULTS
Pain importance and endometriosis lesion size are somewhat linked. In the case of chronic pains, endometriosis lesions are not always the only cause of the pain. Imaging consists mostly of MRI and transvaginal ultrasonography. Treatment must be offered to patients with painful endometriosis. Hormonal treatment meant to cause amenorrhea is recommended to improve dysmenorrhea, dyspareunia and chronic pains. Endometriosis should be confirmed by pathological or surgical findings, before prolonged treatment is undergone. Prolonged postoperative amenorrhea significantly decreases pain and lesion relapse. Surgical treatment is effective on painful symptoms and is recommended in the event of painful endometriosis. Undergoing surgery is recommended only if individual benefit exceeds risk.


CONCLUSIONS
Surgical treatment should aim at improving symptoms rather than systematically removing every endometriosis lesion. Diagnosis of endometriosis lesion at an early stage is currently a major part of public health policy.
Clinique gynécologique et obstétricale, CHU de Rouen, 76000 Rouen, France.
H
H
Roman
N
N
Bourdel
J
J
Rigaud
D
D
Delavierre
J-J
JJ
Labat
L
L
Sibert
D002908:Chronic Disease; D004715:Endometriosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000209:etiology*