Care Pathway
Coordinated management of endometriosis
FHU FRAME offers a structured and multidisciplinary care pathway for patients with endometriosis and adenomyosis. Through collaboration between the hospitals within the network, patients benefit from coordinated management designed to optimize diagnosis, therapeutic decision-making, and long-term follow-up.
This pathway is based on the combined expertise of specialists in gynecology, imaging, pelvic surgery, reproductive medicine, pain management, and social sciences. This comprehensive approach makes it possible to tailor management to the different forms of the disease and to the specific needs of each patient.
Steps
Step 1: Diagnosis and initial assessment
The care pathway generally begins with a specialized gynecology consultation, during which the patient’s symptoms and medical history are assessed.
This first step may include:
- A detailed clinical interview
- A gynecological examination
- A specialized pelvic ultrasound
- A pelvic MRI when necessary
The aim is to identify the different forms of endometriosis or adenomyosis, assess their severity, and guide the patient toward the most appropriate therapeutic strategy.
Step 2: Multidisciplinary discussion
In complex situations, patient cases may be discussed during multidisciplinary team meetings involving several specialists:
- Gynecologists
- Radiologists
- Digestive surgeons or urologists
- Pain specialists
- Reproductive medicine physicians
These meetings make it possible to establish a personalized therapeutic strategy, taking into account symptoms, pregnancy plans, and disease progression.
Step 3: Therapeutic management
The management of endometriosis may combine different therapeutic approaches depending on the clinical situation.
Medical treatment
Hormonal treatments may be offered to reduce pain and limit lesion progression.
Specialized surgery
When symptoms persist or when lesions are complex, specialized surgery may be considered. The centers within the network have recognized expertise in the surgical management of deep endometriosis.
Pain management
Specific approaches may be offered for the management of chronic pain, including pharmacological treatments and non-pharmacological approaches.
Fertility and reproduction
When endometriosis affects fertility, patients may be referred to specialized reproductive medicine consultations in order to assess the available therapeutic options.
Step 4: Follow-up and support
As endometriosis is a chronic disease, long-term follow-up is essential. Patients benefit from regular support in order to:
- Adjust treatment when necessary
- Monitor disease progression
- Take into account the impact on fertility and quality of life
The centers within the network also work closely with patient associations in order to promote information, support, and therapeutic education.
A care pathway integrated with research
The care pathway offered within FHU FRAME is closely linked to the consortium’s clinical and translational research activities. Patients may therefore, if they wish, participate in studies aimed at improving the understanding of the disease, developing new diagnostic tools, or evaluating innovative therapeutic approaches.
This close integration between care and research is one of the cornerstones of FHU FRAME and contributes to the continuous improvement of patient management.