[Screening and management of endometriosis by primary care physicians]
G Ducarme1, L Planche2, A Lebœuf3
1Service de Gynécologie Obstétrique, Centre Hospitalier Départemental, 85000 La Roche sur Yon, France.
Objective:
Analyze knowledge and practices of general practitioners concerning the screening and treatment of endometriosis in primary care.
Methods:
Observational study carried out with general practitioners in a healthcare area using an anonymous online questionnaire about symptoms, screening and their management of endometriosis. Responses were analyzed according to the general practitioners' sex, age and practice in gynecology.
Results:
Sixty-nine general practitioners (69/458 ; 15.1%) responded. Women (18.4% vs. 9.7% : P=0.02), between 40 and 59 years old (26.5% vs. 0 ; P<0.01), with additional training in gynecology (27.2% vs. 3.0%; P<0.01) had significant activity in gynecology. Typical symptoms of endometriosis were experienced by 76.8% general practitioners, but only 36% "often" or "always" referred to endometriosis when faced with these symptoms. Additional training in gynecology, mostly carried out by women, between 40 and 59 years old, had a positive impact on the evocation of endometriosis in the face of these symptoms. If endometriosis was suspected, 72.5% GPs immediately ordered pelvic ultrasound and 85.5% for analgesics, but 42% referred the woman to a gynecologist.
Conclusion:
The general practitioner has a key role in the screening and initial management of endometriosis in primary care. The practice and continuing education of general practitioners in gynecology has a significant impact in improving the screening and initial management of endometriosis.
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