3.64 CME

Perawatan Multidisiplin Endometriosis, Pengalaman Pusat Lokal

Pembicara: Dr. Charles Badr Nagy Rafael

Consultant Obstetrics & Gynecology, Medcare Women & Children Hospital

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Keterangan

Multidisciplinary care for endometriosis involves collaboration among various medical specialists to provide comprehensive and individualized management for this complex condition. In many local centers, a team approach is employed to address the diverse aspects of endometriosis, including pain management, fertility concerns, and overall quality of life. A typical multidisciplinary team may include gynecologists with expertise in minimally invasive surgery for endometriosis excision, pain specialists, reproductive endocrinologists for fertility concerns, colorectal surgeons for cases involving bowel endometriosis, and physical therapists specializing in pelvic floor rehabilitation. Psychologists or mental health professionals may also be part of the team to address the emotional and psychological aspects of living with a chronic condition like endometriosis.

Ringkasan

  • Endometriosis, though often considered a chronic and incurable disease, is actually a complex umbrella term for multiple distinct conditions. Experience suggests that this broad categorization is inaccurate, and a more nuanced approach is needed for effective treatment.
  • The lack of full understanding of the pathogenesis of endometriosis contributes to its under-attention compared to diseases like diabetes and asthma. This results in delayed diagnosis and significant financial impact on healthcare systems due to treatment costs and lost work productivity.
  • Several theories exist regarding the origins and development of endometriosis, but each only explains a specific type. The analogy of "soil and seed" highlights the role of both the endometrial cells and the patient's susceptibility in the disease's progression.
  • Endometriosis manifests in various forms, including peritoneal, ovarian, deep infiltrating (DIE), and rectovaginal. These different types require individualized approaches and treatment strategies, as some DIE cases can potentially be cured.
  • Multidisciplinary care is crucial for accurate diagnosis and safe management of endometriosis. This involves collaboration with colorectal surgeons, urologists, and other specialists to address the complexities of the disease.
  • Preoperative evaluation is key to ensure better outcomes. Standardized surgical techniques, such as the ADIOS strategy (Assessment, Adhesiolysis, Drainage, Exposure, Opening, Excision), are essential to minimize complications and improve patient outcomes.
  • Individualized approaches, rather than solely conservative or radical methods, are recommended. Selected bowel resections after proper patient counseling are considered. The goal is to achieve accurate, safe, and transparent management of the disease.

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