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This paper presents a multidisciplinary clinical protocol for managing endometriosis as a systemic disease, outlining a six-step patient pathway to improve pain control, quality of life, and reproductive outcomes.
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by qwen3.7-flash, 2026-10-11
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This paper proposes a multidisciplinary clinical protocol for managing endometriosis as a systemic, chronic inflammatory disease rather than a purely gynecological condition. The authors synthesize major guidelines from ESHRE, NICE, and ACOG to outline a six-step patient pathway that integrates expertise from surgeons, radiologists, pain specialists, and other healthcare providers. Key steps include early recognition, non-invasive imaging, personalized empirical therapy, expert surgery when indicated, and long-term rehabilitation with outcome monitoring. This paper is centrally about endometriosis — specifically the implementation of a coordinated, multidisciplinary team approach to diagnosis and management.
Abstract
Endometriosis is a chronic, oestrogen-dependent inflammatory disease affecting an estimated 10% of women of reproductive age. The mean diagnostic delay is 6–7 years.Current evidence supports viewing endometriosis beyond a purely gynaecological condition: it combines peripheral inflammation, central sensitisation, genetic susceptibility and associations with other chronic conditions.Objective. To provide a structured protocol integrating the contributions of the gynaecological (endometriosis) surgeon, reproductive medicine specialist, radiologist, pain specialist, colorectal surgeon, urologist, psychologist, pelvic-floor physiotherapist, dietitian and other team members.Methods. The protocol synthesises the ESHRE 2022 guideline, NICE NG73, ACOG guidance, the IDEA ultrasound and WES classification consensus statements, Cochrane reviews and key randomised trials (Section 4). Primary sources and GRADE-based guidelines were prioritised.Results. A six-step patient pathway is proposed: (1) clinical suspicion and early recognition; (2) non-invasive imaging; (3) empirical therapy and a personalised plan; (4) surgery in a centre of expertise where indicated; (5) recovery, rehabilitation and long-term suppression; (6) outcome monitoring (PROMs) and comorbidity screening.Conclusions. Managing endometriosis as a chronic, multisystem condition through a coordinated team may improve pain control, quality of life and reproductive outcomes. The protocol requires local adaptation and independent expert verification before clinical use
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Endometriosis as a Systemic Disease: A Multidisciplinary Clinical Protocol
Authors/Creators
- 1. Viktoriya Hudziak Fertility Management Center
Description
Endometriosis is a chronic, oestrogen-dependent inflammatory disease affecting an estimated 10% of women of reproductive age. The mean diagnostic delay is 6–7 years.
Current evidence supports viewing endometriosis beyond a purely gynaecological condition: it combines peripheral inflammation, central sensitisation, genetic susceptibility and associations with other chronic conditions.
Objective. To provide a structured protocol integrating the contributions of the gynaecological (endometriosis) surgeon, reproductive medicine specialist, radiologist, pain specialist, colorectal surgeon, urologist, psychologist, pelvic-floor physiotherapist, dietitian and other team members.
Methods. The protocol synthesises the ESHRE 2022 guideline, NICE NG73, ACOG guidance, the IDEA ultrasound and WES classification consensus statements, Cochrane reviews and key randomised trials (Section 4). Primary sources and GRADE-based guidelines were prioritised.
Results. A six-step patient pathway is proposed:
(1) clinical suspicion and early recognition;
(2) non-invasive imaging;
(3) empirical therapy and a personalised plan;
(4) surgery in a centre of expertise where indicated;
(5) recovery, rehabilitation and long-term suppression;
(6) outcome monitoring (PROMs) and comorbidity screening.
Conclusions. Managing endometriosis as a chronic, multisystem condition through a coordinated team may improve pain control, quality of life and reproductive outcomes. The protocol requires local adaptation and independent expert verification before clinical use
Files
Endometriosis_Systemic_Disease_MDT_Clinical_Protocol_v1.0.0_Viktoriya_Hudziak.pdf
Additional details
Additional titles
- Alternative title (English)
- Evidence-based diagnosis, medical and surgical treatment, fertility care, rehabilitation and long-term follow-up
Related works
- Is supplemented by
- Report: 10.5281/zenodo.22129194 (DOI)
- Report: 10.5281/zenodo.20364043 (DOI)
- Report: 10.5281/zenodo.20380264 (DOI)
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