The delay in the diagnosis of endometriosis despite its high prevalence rate has remained a major challenge in the management of the condition, experts say.
The experts also say that research on the condition has remained largely underfunded in the country, noting that some women suffer pelvic pain for as long as 10 years before getting the right diagnosis.
The experts who spoke at a two day international conference on endometriosis organised by the Society of Gynaecology and Obstetrics of Nigeria (SOGON) in conjunction with the African Endometriosis Awareness and Support Foundation outlined gaps in examination and unmet needs of women with endometriosis that have delayed progress in treatment.
The experts call for advancements in treatment for this chronic disease that affects millions of women and causes chronic pain, inflammation and infertility.
According to research, endometriosis affects an estimated 1 in 10 reproductive-aged women, or nearly 200 million worldwide. The inflammatory disease includes tissue growth outside the uterus and may severely disrupt a woman’s quality of life and ability to have children.
“Mostly, endometriosis subdivided in three types which include peritoneal superficial endometriosis, ovarian endometriomas, and deep infiltrating endometriosis (DIE). What we know is that usually it’s very often because about 17 to 45 percent of patients with endometriosis will have endometrioma. Its pathology have a very wide range, subtypes and symptoms,” said Julien Bakenga, a Gynecological and obstetrician surgeon at Poitiers, France.
Bakenga who specialises in ultrasound, Endometriosis, Colposcopy and In Vitro Fertilization, speaking on the topic diagnosis of endometriosis current concept, said looking at the clinical outcomes, we have different clinical aspects which are the symptomatic, asymptomatic or sometime endometriosis is found on when we are looking for any infertility symptoms.
According to the expert, pain is one of the major symptoms in endometriosis because it is found that about 70 percent of patients with endometriosis and the physiopathology is not really well known, but we have such hypotheses on it.
He explained that most of the pains can be in relation with hemorrhage of ectopic lesion that will give that recurrence and cycling disease and it could also be in relation with inflammatory process due to hemorrhage of implant lesion, that will liberate the growth factor and that liberation can lead to more addition so in that, it gives more pelvic pain.
“The major and challenging problem in endometriosis as we all know is the delay to diagnosis and an average diagnosis delay goes from six years to 10 years and from the appearance of symptoms to diagnosis, more than 67 percent of patients report their first symptom before the age of 19.
“We are essentially try to analyze what comes for teenagers, because of this big delay for diagnosis, most of young people feel pain but they do not have the diagnosis done and what you have found at the for the last study is that the delay for first symptom to first visit a doctor is longer for a woman Under 19 versus woman After that, age.
The delay between first symptom and diagnosis is also very different; this means that it is a big challenge to try to diagnose this pathology in young patients,” said Bakenga.
Speaking on symptoms, Bakenga further said that dysmenorrhea is a major one because it is found in more than around 93 percent of cases associated usually to cyclic pain or non-cyclic pain.
He explained that endometriosis can have some symptoms in relation with urinary tract, pain in relation with full file of bladder or after urination or during urination noting that some sense of new relation with bowel and diarrhea bowel distension pain can occur during, or after sexual relation.
“In that special group of people in teenagers endometriosis has some element in the environment of the patients and one of the major things is when the young people are pained; usually they can miss school because they have a lot of pain.”
“There is relation with the fact that the lack of efficiency of classical pain medication, the use of contraception for pain purposes could increase the pain.”
“We also found that family history of endometriosis, especially mother history can be an element to take in any important element for diagnosis and the Body mass index (BMI) can be in relation with too,” Bakenga.
Endometriosis is a disorder in which tissue that normally lines the inside of the uterus –the endometrium grows outside the uterus causing pelvic pain especially associated with menstruation.
“It is unfortunate that a condition that negatively impacts millions of women’s physical and emotional well-being, quality of life and wrongfully thought, not to be common in black people many years ago,” says Abayomi Ajayi, chief executive officer (CEO) of Nordica Fertility Centre
Ajayi said the vision of this group is to increase the awareness of endometriosis and our intention is to learn from this variety of experiences to see how we can improve the quality of life of young girls and women through early diagnosis, timely and appropriate management of endometriosis in our continent.
Other experts who spoke at the conference are Carlo Alboni , a member of the department of Gynecology and Obstetrics at university of Modena in Italy. He discussed ‘Ultrasound in the diagnosis and management of endometriosis.’
Also Gerald Harkins is the director for the Minimally Invasive Gynecologic Surgery Fellowship at Penn State Health Milton S. Hershey Medical Center. He spoke on ‘surgery in the management of Endometriosis.’
Hans-Rudolf Tinneberg, president of the European Endometriosis League (EEL) whose main objectives are to extend public awareness and support scientific research in the field of Endometriosis and other co-existing gynecological conditions. He addressed ‘Surgery in bowel deep infiltrative endometriosis.’
Stewart Disu, a Laparoscopic Surgeon and a Consultant Obstetrician and Gynaecologist with the London Northwest Healthcare NHS Trust. Disu, addressed ‘Quality of life in Endometriosis’.
The conference was moderated by the National President of the Society for Gynaecology and Obstetrics of Nigeria (SOGON) Ireti Akinola and Abayomi Ajayi, MD Nordica Fertility Centre and Founder of the Endometriosis Support Group Nigeria.
Themed: ‘Recent Advancements In Endometriosis Diagnosis And Management’, the second part of the conference is scheduled to hold on the 10th of October, 2020, with global speakers like Francisco Carmona from Spain, who will be speaking on Association Of Endometriosis & Infertility: Do We Have Any Evidence? Abayomi Ajayi from Nigeria, who will be discussing the topic: Endometriosis and Infertility: Who Needs ART.
Other speakers are Olarik Musigavong from Thailand, speaking on Management of Endometriosis: To Remove Or Not To Remove; Femi Olarogun from South Africa, will be discussing the topic: Fertility Preservation In Endometriosis; Juwon Alabi from Nigeria, will be speaking on Impact Of Endometriosis On Obstetric and Neonatal Outcomes and Lian Zhang from China, will be speaking on High Intensity Focused Ultrasound In Management Of Endometriosis.
