Endometriosis and Pain

New Perioperative and Non-pharmacological Practices in Endometriosis at the Crossroad of Gynecology and Chronic Pain

Endometriosis is a condition affecting about 10% of childbearing age women. It can begin a few months to a few years after puberty. It causes abdominal and pelvic pain that can be extremely debilitating, affecting the quality of patients life by affecting sexuality and fertility. Psychological repercussions are very important and underestimated. Patient care focuses most often on the "organ pathology treatment ".

This study proposes to evaluate a multidisciplinary patient care by insisting on anatomo-physiological pain management, psychological and bodily, in the perioperative phase.

The main objective is to evaluate benefit of psychological and corporal group management on the overall quality of life of patients with severe endometriosis in terms of endometriotic damage and/or functional and painful repercussions, requiring surgery, before or after this study

Inclusion Criteria:

• Patients >=18 years
• Patients with deep endometriosis according to the CNGOF (collège national des Gynécologues et Obstétriciens Français) and/or chronic pain related to endometriosis according to doctor's evaluation and to the definitions of IASP (International Association for the Study of Pain) and HAS (French National Authority for Health) in treatment failure despite appropriate medical or surgical management of endometriosis
• Patients with social security
• Patients willing to come to all study visits
• Patients who signed their informed consent

Exclusion Criteria:

• Patients unable to participate in group care:

  • Patients with social phobia assessed during the inclusion interview
  • Patients with psychiatric disorders of a psychotic nature: delirium, hallucination, incoherent thoughts
  • Patients with behavioral disorders of hetero-aggressive or self-aggressive type oPatients with a handicap that prevents them following the physical and psychological group sessions (speech disorders, hearing, visual or practical)

• Pregnant women

• Patients planning a change (stop, start) during the study of their psychological management in their current care path.

• Patients planning a change (stop, start) during the study of their treatment by non-medicinal techniques (auriculo-acupuncture, relaxation and self-hypnosis, transcutaneous neurostimulation by TENS)

• Patients suffering from other severe or chronic somatic diseases associated with endometriosis

• Patients with cognitive disorders

• Patients with analgesics addiction (psychoactive substances, morphine substances, etc.)

• Patients protected by law (under guardianship / trusteeship)

• Patients participating in another interventional research that may interfere with the protocol results