Robotic-assisted versus conventional laparoscopic management of deep endometriosis involving the sacral plexus and sciatic nerve: A comparative before and after study.

Objective: To compare robotic-assisted laparoscopy (RAL) and laparoscopy (LPS) for intraoperative and postoperative outcomes, and functional results after a 6-month follow-up period among patients having undergone excision of deep endometriosis (DE) involving the sacral plexus (SP) and sciatic nerve (SN).

Methods: A retrospective analysis of 100 patients included in our prospective database, who underwent surgical eradication of DE involving the SP and SN at our tertiary referral centre between September 2018 and June 2023. Patients were managed by LPS (n = 71) until 2021, and subsequently by RAL (n = 29).

Robotic-Assisted Laparoscopy Excision of a Severe Form of Diaphragmatic Endometriosis: A Retrospective Study of 60 Patients.

Study Objective: To assess the feasibility, effectiveness, and safety of the robotic surgical approach in the treatment of severe diaphragmatic endometriosis (DE).

Design: Retrospective single-center study using data prospectively recorded in the Franco-European Multidisciplinary Institute of Endometriosis database and the National Observatory for Endometriosis database.

Setting: Tertiary referral center.

Bowel endometriosis: Surgical customization is demanding.

Bowel endometriosis is the most common form of severe deep endometriosis. Surgery is an option in case of infertility and/or chronic pain or in the presence of a stenotic lesion. Clinical examination and preoperative imaging must provide an identity card of the lesion so that customized surgery can be proposed.

Intermittent Self-catheterization for Bladder Dysfunction After Deep Endometriosis Surgery: Duration and Factors that Might Affect the Recovery Process.

Study Objective: To assess the duration needed for regaining normal bladder voiding function in patients with postoperative bladder dysfunction requiring intermittent self-catheterization after deep endometriosis surgery and identify risk factors that might affect the recovery process.

Design: Retrospective study based on data recorded in a large prospective database.

Setting: Endometriosis referral center.

Surgical treatment of deep endometriosis: Impact on spontaneous conception.

Deep endometriosis (DE) is the most severe form of endometriosis and is commonly associated with infertility. Surgical treatment of DE appears to increase chances of spontaneous conception in appropriately selected patients wishing to conceive. Identifying, however, the exact impact of DE, and its surgical removal, on natural conception is highly challenging.

Robotic Surgery for Severe Endometriosis: A Preliminary Comparative Study of Cost Estimation.

Study Objective: To compare the postoperative outcomes and the overall expenses between conventional laparoscopy and robotic surgery, in a series of consecutive patients managed for only severe endometriosis in our institute.

Design: A cohort comparative study.

Setting: Center of Excellence in Multidisciplinary Endometriosis Care.

Robotic-assisted versus conventional laparoscopic approach in patients with large rectal endometriotic nodule: the evaluation of safety and complications.

Aim: The aim was to compare postoperative complications in patients undergoing the excision of a rectal endometriotic nodule over 3 cm by a robotic-assisted versus a conventional laparoscopic approach.

Methods: We conducted a retrospective cohort study evaluating prospectively collected data. The main interventions included rectal shaving, disc excision or colorectal resection.

Pain Reduction With an Immersive Digital Therapeutic in Women Living With Endometriosis-Related Pelvic Pain: At-Home Self-Administered Randomized Controlled Trial.

Background: The management of chronic pelvic pain in women with endometriosis is complex and includes the long-term use of opioids. Patients not fully responsive to drugs or ineligible for surgical treatments need efficient alternatives to improve their quality of life and avoid long-term sequelae.

Objective: This randomized controlled trial aimed to assess the effects of repeated at-home administrations of a 20-minute virtual reality (VR) solution (Endocare) compared with a sham condition on pain in women experiencing pelvic pain due to endometriosis.

Long-term risk of repeated surgeries in women managed for endometriosis: a 1,092 patient-series.

Objective: To assess the long-term risk of repeated surgery in women undergoing complete excision of endometriosis by an experienced surgeon and to identify circumstances leading up to repeat surgery.

Design: Retrospective study based on data recorded in a large prospective database.

Setting: University Hospital.

Excision of Deep Rectovaginal Endometriosis Nodules with Large Infiltration of Both Rectum and Vagina: What Is a Reasonable Rate of Preventive Stoma? A Comparative Study.

Study Objective: To compare postoperative complications and rectovaginal fistula rate in women undergoing excision of large rectovaginal endometriosis requiring concomitant excision of rectum and vagina during 2 time periods with differing policies for preventive stoma confection.

Design: Retrospective before-and-after comparative cohort study on data prospectively recorded in a database. Patients managed from September 2018 to March 2020 (first period) were compared with those managed from April 2020 to June 2022 (second period).

Impact of Laparoscopic Sclerotherapy for Ovarian Endometriomas on Ovarian Reserve.

Study: Objective: To evaluate the impact of laparoscopic sclerotherapy on the management of endometrioma during surgery for deep infiltrative endometriosis (DIE).

Design: Observational study.

Setting: Tivoli-Ducos Clinic, Bordeaux.

Pain Reduction With an Immersive Digital Therapeutic Tool in Women Living With Endometriosis-Related Pelvic Pain: Randomized Controlled Trial.

Background: Chronic pelvic pain is a common and disabling condition in women living with endometriosis. Pharmacological and surgical treatments are not always effective at controlling pain and present important restrictions. Digital therapeutics (DTx) are emerging as major nonpharmacological alternatives that aim to extend the analgesic therapeutic arsenal of patients.

[French clinical practice guidelines developed by a modified Delphi consensus process for oocyte vitrification in women with benign gynecologic disease].

Objectives: To provide clinical practice guidelines about fertility preservation (FP) for women with benign gynecologic disease (BGD) developed by a modified Delphi consensus process for oocyte vitrification in women with benign gynecologic disease.

Methods: A steering committee composed of 14 healthcare professionals and a patient representative with lived experience of endometriosis identified 42 potential practices related to FP for BGD. Then 114 key stakeholders including various healthcare professionals (n=108) and patient representatives (n=6) were asked to participate in a modified Delphi process via two online survey rounds from February to September 2020 and a final meeting.

Oocyte Vitrification for Fertility Preservation in Women with Benign Gynecologic Disease: French Clinical Practice Guidelines Developed by a Modified Delphi Consensus Process.

International guidelines are published to provide standardized information and fertility preservation (FP) care for adults and children. The purpose of the study was to conduct a modified Delphi process for generating FP guidelines for BGD. A steering committee identified 42 potential FP practices for BGD.

Large ovarian endometriomas are associated with high pre-operative anti-Müllerian hormone concentrations.

Research Question: Are large ovarian endometriomas associated with high pre-operative anti-Müllerian hormone (AMH) concentrations?

Design: Data from 332 women who underwent AMH measurement before surgery for endometriosis were prospectively recorded in a large database. Univariate analysis compared AMH concentrations in terms of the patients' baseline characteristics. A multivariate model was used to identify variables having an independent relationship with AMH concentration.

Prevalence, intensity, impact on quality of life and insights of dysmenorrhea among French women: A cross-sectional web survey.

Objective: Determine prevalence and intensity of primary dysmenorrhea in a sample of French women and assess impact on daily life and Quality of Life, care pathway and pain management METHODS: This cross-sectional web-based survey was conducted from December 192018 through January 102019 among a representative sample of 3001 French women aged 16 to 50.

Results: 2375 women (79%) reported having pain during menstruation, currently or in the past. 52% reported being currently affected, 27% had been affected in the past and 21% never suffered.

Pregnancy outcomes in women with history of surgery for endometriosis.

Objective: To assess the relationship between history of surgery for endometriosis and adverse obstetrical outcomes.

Design: Retrospective study using prospectively recorded data.

Setting: Referral center.

[Early postoperative complications in a multidisciplinary surgical center exclusively dedicated to endometriosis: A 491-patients series].

Objective: The objective of our study is to present the activity volume and postoperative complications in a center exclusively destined to endometriosis surgery.

Methods: Retrospective mono-centric study analyzing data collected prospectively in patients surgically managed for endometriosis from September 2018 to August 2019.

Results: Four hundred and ninety-one patients underwent surgery for endometriosis during 12 consecutive months: 268 for colorectal localizations (54.

Progression of deep infiltrating rectosigmoid endometriotic nodules.

Study Question: What is the risk of progression of deep endometriotic nodules infiltrating the rectosigmoid?

Summary Answer: There is a risk of progression of deep endometriotic nodules infiltrating the rectosigmoid, particularly in menstruating women.

What Is Known Already: Currently, there is a lack of acceptance in the literature on the probability that deeply infiltrating rectosigmoid endometriotic nodules progress in size.

Study Design, Size, Duration: We conducted a monocentric case-control study between September 2016 and March 2018 at Rouen University Hospital.

Pregnancy Rates After Surgical Treatment of Deep Infiltrating Endometriosis in Infertile Patients With at Least 2 Previous In Vitro Fertilization or Intracytoplasmic Sperm Injection Failures.

Study Objective: To assess the postoperative probabilities of pregnancy in patients with deep infiltrating endometriosis (DIE) and ≥2 previous in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) failures.

Design: Retrospective study using data prospectively recorded in the North-West Inter Regional Female Cohort for Patients with Endometriosis (CIRENDO) database.

Setting: University tertiary referral center.

Relationship between Patient Age and Disease Features in a Prospective Cohort of 1560 Women Affected by Endometriosis.

Objective: To assess the relationship between age, location of the disease, and surgical procedures performed in patients undergoing surgical management of endometriosis.

Design: Retrospective study using data prospectively recorded in the North-West Inter Regional Female Cohort for Patients with Endometriosis database.

Setting: University tertiary referral center.

High postoperative fertility rate following surgical management of colorectal endometriosis.

Study Question: What are fertility outcomes in patients surgically managed for large deep endometriosis infiltrating the rectum who intend to get pregnant postoperatively?

Summary Answer: Surgical management for rectal endometriosis is followed by high pregnancy rates, with a majority of natural conceptions.

What Is Known Already: Optimal management such as surgery versus first-line ART for patients with severe deep endometriosis who desire pregnancy is not defined.

Study Design, Size, Duration: The study included the patients enrolled in ENDORE randomized trial who attempted pregnancy after the surgery.

[The Rouen Expert center in the diagnosis and multidisciplinary management of endometriosis: A French pilot experiment].

Objectives: To retrospectively describe the activity of the Diagnosis and Multidisciplinary Management of Endometriosis Expert Center of Rouen-Normandy, before and after official identification by French Health Authorities.

Methods: Retrospective study of the main activities of an Expert Center, from January 2013 to March 2018.

Results: The Endometriosis Expert Center of Rouen-Normandy is a regional network, organised as a pyramid with a Referral Center at the top (the Rouen University Hospital) leading a network of public and private Expertise Centers below in Normandy.

The definition of Endometriosis Expert Centres.

Endometriosis is a common condition that causes pain and infertility. It can lead to absenteeism and also to multiple surgeries with a consequent risk of impaired fertility, and constitutes a major public health cost. Despite the existence of numerous national and international guidelines, the management of endometriosis remains suboptimal.

[Definition of endometriosis expert centres].

Objectives: The Collège national des gynécologues obstétriciens français (CNGOF), in agreement with the Société de chirurgie gynécologique et pelvienne (SCGP), has set up a commission in 2017 to define endometriosis expert centres, with the aim of optimizing endometriosis care in France.

Methods: The committee included members from university and general hospitals as well as private facilities, representing medical, surgical and radiological aspects of endometriosis care. Opinion of endometriosis patients' associations was obtained prior to writing this work.