Candiani Massimo
Department of Obstetrics and Gynecology, University of Milan, Milan, Italy.
Drugs Today (Barc). 2005 Jul;41 Suppl A:11-5.
The role of laparoscopy in the diagnosis and medical treatment of endometriosis is changing. Diagnosis based on laparoscopic visualization of endometriotic implants alone is unreliable. However, clinical diagnosis based on noninvasive techniques such as history, symptoms and physical examination is correct in 78-87% of cases. The current approach to treatment of chronic pelvic pain in Italy involves first-line treatment with oral contraceptives or nonsteroidal antiinflammatory drugs. Second-line treatment involves gonadotropin-releasing hormone (GnRH) agonists administered with or without add-back therapy. Current guidelines suggest that in the absence of adnexal masses, estrogen-progesterone combinations can be administered without the need for preliminary laparoscopy.
腹腔镜检查在子宫内膜异位症的诊断和治疗中所起的作用正在发生变化。仅基于腹腔镜检查发现子宫内膜异位植入物进行诊断并不可靠。然而，基于病史、症状和体格检查等非侵入性技术进行的临床诊断在78%至87%的病例中是正确的。意大利目前治疗慢性盆腔疼痛的方法包括一线使用口服避孕药或非甾体抗炎药进行治疗。二线治疗包括使用促性腺激素释放激素（GnRH）激动剂，可联合或不联合反向添加疗法。目前的指南建议，在没有附件包块的情况下，可以在无需进行初步腹腔镜检查的情况下给予雌激素 - 孕激素联合治疗。
