Validation of a score to guide endometriosis therapy for the non-specialized gynecologist.
OBJECTIVE
To validate a tool-the ECO system-developed to guide non-specialized gynecologists in the treatment of patients with suspected endometriosis in outpatient clinics.


METHODS
In a retrospective study, data were assessed from patients presenting to a center in Brazil or a center in Germany with suspected endometriosis and pelvic pain between July 2012 and June 2013. Data reviewed included patient complaints, clinical extent of disease, patient goals, recent use of medication, previous pelvic surgeries, visual analog pain scale, treatment provided, and histopathology after surgery. Data were transformed into a score according to the ECO system (0-6) indicating the suggested management, which was compared with the approach used in the study hospitals.


RESULTS
Among 166 patients, 78 (47.0%) were medically treated and 88 (53.0%) underwent therapeutic laparoscopy. All 3 patients scoring 2 had undergone hormonal treatment. Among 51 patients scoring 3, 49 (96.1%) were clinically managed and 2 (3.9%) underwent surgery. Among 52 patients scoring 4, 26 (50.0%) had undergone medical treatment and 26 (50.0%) surgical treatment. All 56 patients who scored 5 and the four patients who scored 6 underwent surgery.


CONCLUSIONS
The ECO system seems to effectively represent the management of patients with endometriosis in specialized services.
Department of Gynecology, Federal Fluminense University, Niterói, Brazil.
Ricardo B
RB
Lasmar
Endoscopic Gynecology Service, Central Hospital Aristarcho Pessoa, Rio de Janeiro, Brazil.
Bernardo P
BP
Lasmar
Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Roger Keller
RK
Celeste
Clinic of Gynecology, Obstetrics and Gynecological Oncology, Pius-Hospital Oldenburg, and School of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany.
Angelika
A
Larbig
Clinic of Gynecology, Obstetrics and Gynecological Oncology, Pius-Hospital Oldenburg, and School of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany. Electronic address: rudy-leon.dewilde@pius-hospital.de.
Rudy L
RL
De Wilde
D000293:Adolescent; D000328:Adult; D001938:Brazil; D004715:Endometriosis / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D005260:Female; D005858:Germany; D006176:Gynecology / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
Approach; ECO system; Endometriosis