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Current practice for the laparoscopic diagnosis and treatment of endometriosis: a national questionnaire survey of consultant gynaecologists in UK
Author(s) -
Moses Sharon H.,
Clark T. Justin
Publication year - 2004
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2004.00429.x
Subject(s) - medicine , endometriosis , pelvic pain , general surgery , laparoscopy , laparoscopic surgery , clinical trial , gynecology , family medicine , surgery
Objective To determine current practice regarding laparoscopic diagnosis and treatment of endometriosis. Design A prospective questionnaire survey. Setting The United Kingdom. Population All 1411 UK consultant gynaecologists identified from a Royal College of Obstetricians and Gynaecologists database. Methods A postal questionnaire was sent to all consultants with reply paid envelopes. A postal reminder was sent three months following the initial questionnaire. Main outcome measure Current practice for the laparoscopic diagnosis and treatment of endometriosis and willingness to participate in a randomised trial. Results The response rate was 66% (893/1411). Diagnostic laparoscopy was performed by 87% (772/893) of respondents. Seventy‐six percent of these (58/772) were confident to visually diagnose endometriosis and 6% (47/772) routinely verified the diagnosis histologically. Laparoscopic surgery was routinely undertaken by 41% (318/772) of respondents. Ablative therapy was the most frequently employed technique utilised [620/653 (95%)] and electrodiathermy was the most popular energy modality (80%). Among respondents expressing a preference, excision of disease was believed to be more effective, but less safe compared with ablation. One‐third of respondents (273/893) were willing to enter patients into a randomised controlled trial to compare laparoscopic treatments for pelvic pain associated with endometriosis. Conclusion Laparoscopic surgery for endometriosis associated with pelvic pain is routinely undertaken by a large number of UK consultant gynaecologists, but techniques used and beliefs about efficacy vary. In view of this division of opinion regarding the relative roles of laparoscopic treatment methods, a randomised trial comparing the efficacy and safety of these methods is urgently needed.