Introduction: Endometriosis is a chronic, oestrogen-dependant disease that affects 6-10% of women of reproductive age and 35-50% of women suffering from infertility.(1)
It is defined by the ectopic location of endometrial glands and stroma outside the uterine cavity. It is a diffuse pathology, thus, every part of the body can be affected. According to the locations of the endometrial implants, the symptoms will differ, yet pain, remains the main symptom.
Several theories have tried to explain the pathogenesis of this disorder: implementation of endometrial tissue via retrograde menstruation, vascular or lymphatic dissemination or coelomic metaplasia.
In this context, it is highly important to investigate the current knowledge of the mechanisms of pain, to review the available treatments and also their outcomes. Furthermore, there is a need to develop a more efficient care of these affected women.
Objectives: 1) Review the current knowledge about the pathogenesis of the endometriosis and the pain associated symptom. Highlight the current treatments offered to these affected women and their outcomes. 2) Assess the impact of the surgery on the pain and the quality of life of the women with endometriosis.
Method: First, we reviewed the pathophysiology and pathogenesis of endometriosis. Then, as pain, is the cardinal symptom, we highlighted the underlying mechanisms responsible for the development of pain. Finally, we focused on the current non-surgical and surgical treatments and reviewed the outcomes they’ve showed up.
Simultaneously, we have set up a prospective study that includes women with endometriosis and for whom a surgery has been planned. Thereby, an application to the ethic committee has been made and accepted (CER-VD, 2020-02493). This study will allow a follow-up of affected women through questionnaires (pre-operative, surgical and post- operative questionnaires) including items about these women’s global health.
Conclusion: This review allowed to assess the current knowledge about the pathogenesis of the endometriosis and the pain. Much still need to be understood about the physiopathology, the risk-factors and the origins of the pain.
Finally, the implementation of a closed follow-up via the prospective study, will allow to assess the impact of the surgery on the pain and the quality of life of these patients. Furthermore, it may help to have a better understanding of the link between the symptoms and the disease.
All of this will contribute to develop better care of women with endometriosis and to offer an appropriate and individualised treatment. Finally, it will allow to reduce the rate of reintervention and increase the efficiency of surgery.