Validation of a score to guide endometriosis therapy for the non-specialized gynecologist

Objective: To validate a tool-the ECO system-developed to guide non-specialized gynecologists in the treatment of patients with suspected endometriosis in outpatient clinics. Methods: In a retrospective study, data were assessed from patients presenting to a center in Brazil or a center in Germany with suspected endometriosis and pelvic pain between July 2012 and June 2013. Data reviewed included patient complaints, clinical extent of disease, patient goals, recent use of medication, previous pelvic surgeries, visual analog pain scale, treatment provided, and histopathology after surgery. Data were transformed into a score according to the ECO system (0-6) indicating the suggested management, which was compared with the approach used in the study hospitals. Results: Among 166 patients, 78 (47.0%) were medically treated and 88 (53.0%) underwent therapeutic laparoscopy. All 3 patients scoring 2 had undergone hormonal treatment. Among 51 patients scoring 3, 49 (96.1%) were clinically managed and 2 (3.9%) underwent surgery. Among 52 patients scoring 4, 26 (50.0%) had undergone medical treatment and 26 (50.0%) surgical treatment. All 56 patients who scored 5 and the four patients who scored 6 underwent surgery. Conclusion: The ECO system seems to effectively represent the management of patients with endometriosis in specialized services. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.