Title : Emerging trends in the treatment of endometriosis. It is time to know what we do not know. A prospective cohort pilot multisite study
Abstract:
Endometriosis is one of the most challenging gynaecological conditions that primarily affects women of childbearing age. It mainly presents with pelvic pains and subfertility, causing a significant impairment in the quality of life. Unfortunately, there is no radical cure for endometriosis. The management of endometriosis, whether medical or surgical, mainly focus on alleviating pain and improving the quality of life. Nevertheless, for 20-40% of women, symptoms persist following surgical and/or pharmacological treatment. Alternative ways of managing pains are needed, which need to consider contemporary pain science and all biopsychosocial aspects of the persistent pain experience. Current clinical practice guidelines provide minimal guidance for physiotherapy care of women with endometriosis, and none of the accredited or provisional endometriosis centres across the United Kingdom has got a physiotherapist in their endometriosis management teams as it is not a pre-requisite to be accredited as an endometriosis centre in the UK. At London North West Endometriosis centre we conducted a prospective cohort pilot study of 10 patients across our three sites: central Middlesex, Ealing and Northwick Park Hospitals. We recently started recruiting for the first randomised controlled trial for the effect of physiotherapy on endometriosis agony. Physiotherapy as a discipline provides conservative therapies, pain management education classes, group sessions and one to one, face to face and online, manual physiotherapy and pelvic floor exercises. We conducted on average six sessions over the course of six months for every patient. We recruited 10 patients into our pilot study, and we compared their answers to the BSGE Pelvic Pain Questionnaire at their initial consultation and then at the end of their physiotherapy sessions. Our results showed that more than 90 % of patients had her symptoms improved at the end of the six sessions.
Keywords: Endometriosis, Physiotherapy, pelvic pains.
