The focus in the modern management of endometriosis, in the recent years, has been shifted towards the creation of teams of healthcare professionals with expertise in the management of the disease, in a patient-centred approach1. Although each endometriosis centre may have a different team structure, we suggest a team that consists of an endometriosis surgeon, a colorectal surgeon, a urologist, a fertility specialist, a specialist in chronic pain, a physiotherapist and a psychologist. The combination of their knowledge and skills contributes to the holistic care of patients2.
Why do we need a team of specialists? In the centre of the core team is the gynaecologist who has the initial contact with the patient and the overall responsibility of the care. Since deep infiltrating endometriosis can affect the bowel and the urinary system, in such cases, it is imperative to involve a colorectal surgeon and/or urologist.
In cases of co-existent infertility, the cooperation with a fertility specialist is important. Since endometriosis is a complex disease and surgery does not always guarantee the complete resolution of symptoms, cooperation with a chronic pain specialist and a physiotherapist with an interest in pelvic physiotherapy is helpful in such cases. A psychologist participates in cases where the pain may have a psychological component.
Although the active participation of all the above members is not required in every single case, their cooperation and exchange of opinion at regular intervals remain important.
References:
- Ebert A.D. et al., on behalf of the Endometriosis Research Foundation, and the European Endometriosis League. Implementation of certified endometriosis centers : 5 year experience in German speaking Europe. Gynecol Obstet Invest 2013 ;76 :4-9.
- Ugwumadu L, Chakrabarti R, Williams-Brown E, Rendle J, Swift I, John B, Allen-Coward H, Ofuasia E. The role of the multidisciplinary team in the management of deep infiltrating endometriosis. Gynecol Surg. 2017;14(1):15.