ADVANCES IN THE MANAGEMENT OF ENDOMETRIOSIS: CURRENT DIAGNOSTIC AND THERAPEUTIC APPROACHES (Atena Editora)

Abstract

This scientific article offers a comprehensive overview of endometriosis, covering diagnostic methods and available therapeutic options. The research methodology included a comprehensive search in three academic databases (Google Scholar, Scielo and PubMed) from 2004 to 2023, encompassing articles in English, Portuguese and Spanish. The search used relevant keywords and established inclusion criteria. The diagnosis of endometriosis involves an approach that takes into consideration, clinical evaluation, imaging tests, such as transvaginal ultrasound and magnetic resonance imaging, and analysis of the serum marker CA-125. Laparoscopy is usually necessary for a definitive diagnosis, although it is invasive. Endometriosis treatment is highly personalized, focusing on resolving pelvic pain and managing infertility when present. Therapeutic options include drug treatment, surgery and assisted reproduction treatments. The choice of treatment depends on several factors, such as the stage of the disease and other clinical factors. Drug treatment includes different hormonal approaches, but ovarian suppression alone is not recommended to improve fertility except in preparation for IVF. Surgical therapy ranges from less complex procedures to more extensive interventions, focusing on organ conservation. Conservative surgery is preferred as there is no direct correlation between the extent of the disease and the severity of symptoms. Lesion ablation and adhesiolysis can improve fertility, especially in mild to moderate cases. Therefore, it is concluded that the treatment of endometriosis requires a personalized approach, considering the symptoms, stage of the disease and the patient's reproductive goals, with the aim of providing pain relief and improving quality of life. Diagnosis and treatment must be carefully considered in each case.