Endometriosis - what's new and important

Date Published: 
Tuesday, July 13, 2021
Duration: 
69:49
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Simon Edmonds and Michael Wynn Williams discuss improving the diagnosis and management of endometriosis in New Zealand through early recognition of symptoms, empowering primary health care practitioners to make a suspected diagnosis and commence management along with appropriate and timely referral to specialists.

 

Topics:

  • 00:00 intro
  • 01:53 Endometriosis definition
  • 02:35 Incidence rate
  • 03:27 Pathophysiology
  • 05:15 History
  • 11:44 examination
  • 14:54 Imaging
  • 20:22 diagnosis
  • 29:45 management
  • 34:26 Pain management
  • 40:19 progestins and bones
  • 44:46 GnRH analogues
  • 46:42 Role of the muti-disciplinary team
  • 50:40 lifestyle measures
  • 55:46 Fertility
  • 62:31 health equity
  • 65:23 referral expectations
  • 67:47 take-home messages

 

Take-home messages

  • When a woman presents with dysmenorrhea alone it is usually appropriate to trial a COCP, POP or Mirena as a first-line treatment
  • When secondary symptoms occur, such as dyspareunia, dyschezia, difficulty in falling pregnant and pain outside of the period, consider ultrasound and referral to secondary care
  • Assessing the impact of the woman’s pain on the quality of her life is an important marker for the presence of endometriosis.
  • There are numerous resources out there for women to access to give them more information about the condition
  • Services in secondary care should be moving to a more specialist model, similar to the treatment of gynaecological cancers so that women get an appropriately trained specialist at the first surgery,  who also has access to a multidisciplinary team of healthcare professionals “Centres of Endometriosis Excellence”
  • We should be aiming to move away from diagnostic laparoscopy and repeated laparoscopies as the improvement in pain.

 

Resources

 

Patient resources

Presenter

Simon Edmonds
Gynaecologist

Simon and Michael have worked together for many years as senior gynaecologists. Both of them have extensive experience in the surgical and multidisciplinary management of severe endometriosis, chronic pain and complex gynaecological surgery. They are both involved as board members of the Australasian Gynaecological Endoscopy Society and have been directors for the 2-year AGES fellowship subspecialty training programme, supporting the education and training of future advanced laparoscopic surgeons in Australia and New Zealand.

Michael Wynn Williams
Gynaecologist

Simon and Michael have worked together for many years as senior gynaecologists. Both of them have extensive experience in the surgical and multidisciplinary management of severe endometriosis, chronic pain and complex gynaecological surgery. They are both involved as board members of the Australasian Gynaecological Endoscopy Society and have been directors for the 2-year AGES fellowship subspecialty training programme, supporting the education and training of future advanced laparoscopic surgeons in Australia and New Zealand.

Recognition of Learning Activities

Complete and submit the learning reflection form for CPD/MOPS points provided by The Royal New Zealand College of General Practitioners below for recognition of learning activities.

Learning Reflection Form

www.rnzcgp.org.nz

This presentation is intended for qualified health practitioners professional development and should not be relied upon for any other purpose. Any opinions offered are those of the presenter or other speaker and do not necessarily represent the views of Goodfellow Unit.