Excerpt

This guideline makes recommendations for the diagnosis and management of endometriosis in community services, gynaecology services and specialist endometriosis services (endometriosis centres).

The guideline also covers the care of women with confirmed or suspected endometriosis, including recurrent endometriosis. It includes women who do not have symptoms but have endometriosis discovered incidentally. Special consideration was given to young women (aged 17 and under). The guideline does not cover the investigation of fertility problems related to endometriosis, care of women with endometriosis occurring outside the pelvis, nor postmenopausal women.

Contents

• 1. Introduction
• 2. Guideline summary
  • 2.1. Committee membership, National Guideline Alliance (NGA) staff and acknowledgements
  • 2.2. Algorithm
  • 2.3. Other versions of the guideline
  • 2.4. Schedule for updating the guideline
  • Acknowledgements
• 3. Development of the guideline
  • 3.1. What is a NICE clinical guideline?
  • 3.2. Remit
  • 3.3. Who developed this guideline?
  • 3.4. What this guideline covers
  • 3.5. What this guideline does not cover
  • 3.6. Relationship between the guideline and other NICE guidance
• 4. Guideline development methodology
  • 4.1. Developing the review questions and protocols
  • 4.2. Searching for evidence
  • 4.3. Reviewing research evidence
  • 4.4. Method of combining clinical studies
  • 4.5. Appraising the quality of evidence
  • 4.6. Developing recommendations
• 5. Organisation of care
  • 5.1. Specialist services
  • 5.2. Timing: association between duration of symptoms before laparoscopy and treatment outcomes
• 6. Signs and symptoms of endometriosis (monitoring and referral)
  • 6.1. Introduction
  • 6.2. Description of clinical evidence
  • 6.3. Summary of included studies
  • 6.4. Economic evidence
  • 6.5. Clinical evidence statements
  • 6.6. Evidence to recommendations
  • 6.7. Recommendations
• 7. Information and support
  • 7.1. Introduction
  • 7.2. Description of clinical evidence
  • 7.3. Summary of included studies
  • 7.4. Clinical evidence
  • 7.5. Economic evidence
  • 7.6. Clinical evidence statements
  • 7.7. Evidence to recommendations
  • 7.8. Recommendations
  • 7.9. Research recommendations
• 8. Risk of cancer of the reproductive organs
  • 8.1. Introduction
  • 8.2. Description of clinical evidence
  • 8.3. Economic evidence
  • 8.4. Clinical evidence statements
  • 8.5. Evidence to recommendations
  • 8.6. Recommendations
• 9. Diagnosis
  • 9.1. Introduction: diagnostic testing
  • 9.2. Ultrasound
  • 9.3. Biomarkers
  • 9.4. Magnetic resonance imaging (MRI)
  • 9.5. Surgical diagnosis with or without histological confirmation
• 10. Staging systems
  • 10.1. Introduction
  • 10.2. Description of clinical evidence
  • 10.3. Clinical evidence profile
  • 10.4. Economic evidence
  • 10.5. Clinical evidence statements
  • 10.6. Evidence to recommendations
  • 10.7. Recommendations
• 11. Management strategies
  • 11.1. Pharmacological management
  • 11.2. Non-pharmacological management
  • 11.3. Surgical management and combinations of treatment
  • 11.4. Hysterectomy (with or without oophorectomy) in combination with surgical management
• 12. Pharmacological, non-pharmacological, surgical and combination management strategies - if fertility is a priority
  • 12.1. Introduction
  • 12.2. Summary of included studies
  • 12.3. Clinical evidence profile
• 13. References
• 14. Glossary and abbreviations
• Appendices
  • Appendix A. Scope
  • Appendix B. Stakeholders
  • Appendix C. Declarations of interest
  • Appendix D. Review Protocols
  • Appendix E. Search strategies
  • Appendix F. Summary of identified studies
  • Appendix G. Evidence tables
  • Appendix H. Excluded studies
  • Appendix I. Forest plots
  • Appendix J. GRADE tables
  • Appendix K. Health economics
  • Appendix L. Network Meta-Analysis

Version 1.0 Final

Developed by the National Guideline Alliance, hosted by the Royal College of Obstetricians and Gynaecologists

Disclaimer: Healthcare professionals are expected to take NICE clinical guidelines fully into account when exercising their clinical judgement. However, the guidance does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of each patient, in consultation with the patient and/or their guardian or carer.