title: [Endometriosis: necessary and sequential therapeutic procedures and guidelines].
abstract: OBJECTIVE
  To define the actual guidelines about the therapy of endometriosis.
  
  
  METHODS
  A brief review of the literature for the correct diagnosis of endometriosis and the medical and surgical approach.
  
  
  RESULTS
  It is well accepted that the gold standard of endometriosis diagnosis is the direct vision of the disease with laparoscopy or the presence of endometriosis implants in vagina or cervix. Staging must be performed along with the distribution, and depth and bowel involvement must be noted. Symptoms intensity is not related to the degree of endometriosis. Therapy, medical or surgical, should be chosen in relation to symptoms and the disease degree, keeping in mind that surgery is the approach that may offer better results.
  
  
  CONCLUSIONS
  The direct vision of the disease is the only method to obtain the correct diagnosis and an accurate staging. However, ultrasound can be helpful in cases of pelvic localization and in the follow-up of the disease. Moreover, MRI can be employed, especially in cases with particular endometriosis implant, e.g. gluteus muscle. Surgery offers the best results but some medical therapy, especially hormonal therapy, is often employed for the relief of pains.
authors.affiliation: Università di Modena e Reggio Emilia, Italy. vjasonni@libero.it
authors.forename: Valerio M
authors.initials: VM
authors.lastname: Jasonni
mesh_terms: D000293:Adolescent; D000328:Adult; D017763:Autonomic Denervation; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000379:methods; D018450:Disease Progression; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D004958:Estradiol / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D010535:Laparoscopy; D017699:Pelvic Pain / Q000188:drug therapy / Q000209:etiology; D017410:Practice Guidelines as Topic; D011372:Progestins / Q000627:therapeutic use
chemical_list: D011372:Progestins; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol