SEUD President Université Paris Descartes, Sorbone

Endometriosis: a holistic management
Professor Charles Chapron, France
SEUD President
Université Paris Descartes, Sorbone Paris Cité, Faculté de Médecine, Assistance Publique –
Hôpitaux de Paris (AP- HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier
Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive
Medicine (Professor Chapron), Paris, France.
Endometriosis, which is defined as the presence of endometrial-like tissue outside of
the uterine cavity, is a public health issue that bears an important economic burden. There
are three endometriosis phenotypes: peritoneal superficial (SUP), ovarian endometrioma
(OMA) and deep infiltrating endometriosis (DIE).
There are three therapeutic options for endometriosis management
1) Surgery is efficient, not only for managing pelvic pain and treatment of
endometriosis-related infertility, but also for improving quality of life. Nevertheless,
the benefits of surgery should not obscure the fact that interventions can be
associated with adverse outcomes. An important issue is that endometriosis has a
high potential risk for recurrence which many reports have attributed to incomplete
surgical procedures. One of the main question in the endometriosis surgical
management is to know if it is a “real recurrence or persistence”.
2) Medical treatment, which can be efficient for painful patients.
3) Assisted Reproductive technologies (ART): endometriosis, which is an abdominopelvic inflammatory disease is an excellent indication for ART in cases of
endometriosis-related infertility
In this lecture we will precise the different therapeutic options to optimize the
endometriosis management according to the desire of the patient, clinical situations (pelvic
pain and/or infertility), endometriosis phenotypes
and associated adenomyosis.