{"id":103723,"date":"2025-05-15T14:26:12","date_gmt":"2025-05-15T14:26:12","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/103723\/"},"modified":"2025-05-15T14:26:12","modified_gmt":"2025-05-15T14:26:12","slug":"are-europes-specialist-centers-the-answer-to-endometriosis","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/103723\/","title":{"rendered":"Are Europe\u2019s Specialist Centers the Answer to Endometriosis?"},"content":{"rendered":"

Endometriosis<\/a> affects roughly 190 million<\/a> (10%) women and girls of reproductive age globally. Still, and despite its debilitating symptoms, it can take years to get a diagnosis. For example, it takes about 7.4 years for a diagnosis in the Netherlands<\/a>, almost 9 years in the UK<\/a>, and 10.4 years in Austria and Germany<\/a>. This lengthy wait for a diagnosis and access to treatments can mean disease progression, with worsening physical symptoms, more complex cases, and risk for permanent organ damage and infertility<\/a>.<\/p>\n

Now, some European countries are offering dedicated endometriosis centers to ensure better management of severe forms of the disease, which experts say have been increasing. These centers are also providing wider training for doctors in other parts of the European Union and further afield.<\/p>\n

Italy: Endometriosis Is a Sign of the Times<\/p>\n

Paola Vigano, PhD, is the laboratory director of the infertility unit at Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Milano, one of Italy\u2019s largest hospitals with a dedicated endometriosis center. She calls the rise in endometriosis an \u201cevolutionary mismatch\u201d driven by the change in reproductive patterns of women.<\/p>\n

\u201cThe age of menarche has dramatically decreased, the age of conception has increased, the number of kids women are having has decreased, and breastfeeding rates have declined. We have a lot of menstruation compared with the 18th and 19th centuries \u2014 and that\u2019s the basis of endometriosis,\u201d said Vigano, who was on the board of the World Endometriosis Society from 2019 to 2023. \u201cOf course, there may be other mechanisms, such as pollutants and bacteria, that are contributing to the increase.\u201d\u00a0<\/p>\n

Vigano told Medscape Medical News that the expansion of expert endometriosis centers across Europe is contributing to the improved management of the disease, particularly complex cases.\u00a0<\/p>\n

\u201cIn Europe, things are improving. There\u2019s more money for research, more countries have specialized centers, and there\u2019s more recognition of the disease, but we still have things that are missing that could be done to improve the lives of women.\u201d\u00a0<\/p>\n

One challenge is choosing the most appropriate treatment option.\u00a0<\/p>\n

\u201cIt\u2019s a difficult disease to treat and it has a big psychological impact on women. It\u2019s a delicate balance to find the right intervention because some doctors want to operate when you can manage the symptoms using the oral contraceptive<\/a> pill,\u201d Vigano explained.\u00a0<\/p>\n

She added that despite existing diagnostic delays in Italy, the country has a good working group on endometriosis, with hospitals meeting every year.\u00a0<\/p>\n

France: Multidisciplinarity Is Key<\/p>\n

In Bordeaux, France, Institut Franco-Europ\u00e9en Multidisciplinaire d\u2019Endom\u00e9triose (IFEM Endo) is a specialized center that undertakes more than 8000 consultations and 1000 surgeries every year.\u00a0<\/p>\n

\"photoHorace Roman, MD<\/p>\n

Professor Horace Roman, MD, founding member of IFEM Endo and a gynecologic surgeon specializing in endometriosis, told Medscape Medical News that endometriosis centers are well-positioned to respond to the growing number of complex endometriosis cases.\u00a0<\/p>\n

\u201cIn our center, we perform a large number of procedures for rare endometriosis. This is routine for us, and it should be for each expert center worldwide,\u201d he said.<\/p>\n

Roman began treating endometriosis patients in 2004. It was only 1 year later when he decided he wanted to dedicate his surgical career to the condition. \u201cBut in 2005, this idea was found to be very strange because no one believed that I\u2019d have enough patients to keep me busy. But progressively the number of patients increased to the point that, since 2011, my surgical activities have only been in endometriosis.\u201d\u00a0<\/p>\n

A key part of managing complex endometriosis cases is having a multidisciplinary team on hand to provide a wide range of care necessary to improving patients\u2019 quality of life.<\/p>\n

IFEM Endo has gynecologic surgeons who are exclusively dedicated to endometriosis surgeries, colorectal surgeons, gastroenterologists, urologists including one specialized in bladder function, radiologists, physiotherapists, and specialists in pain treatments and assisted reproductive technologies.\u00a0<\/p>\n

The French center also aims to expand expert knowledge on the disease across the continent and beyond by providing fellowships, workshops, and masterclasses on a range of endometriosis surgeries.\u00a0<\/p>\n

Hungary: Improving Skills Among Healthcare Professionals<\/p>\n

Associate professor Attila Bokor, MD, PhD, is the coordinator of the endometriosis center at Semmelweis University in Budapest, Hungary, the largest specialized center of its kind in the country. It sees about 2500 patients every year, 15% of whom are from outside Hungary. Bokor told Medscape Medical News that, in recent years, he has seen an increasing number of patients with a very late diagnosis and complex cases.\u00a0<\/p>\n

\"photoAttila Bokor, MD, PhD<\/p>\n

\u201c[Patients] often see between five and seven specialists before they get a diagnosis. We only perform surgery when everything else fails, and then our major goal is to preserve organ function after surgery and improve quality of life,\u201d he said.<\/p>\n

\u201cFor me, it\u2019s unacceptable that there\u2019s still a diagnostic delay as long as 10 years in Europe\u2026one of the most common misdiagnoses is appendicitis<\/a>, which is unbelievable because they are completely different diseases.\u201d\u00a0<\/p>\n

Key to decreasing diagnostic delay is increasing awareness, knowledge, and skills among healthcare professionals. Bokor and colleagues from Semmelweis University provide a range of training to specialists from across Europe, including some from Central and Eastern Europe who lack specialized training in complex endometriosis surgeries.\u00a0<\/p>\n

\u201cWe provide training on the diagnosis of endometriosis, transvaginal sonography, and dedicated surgical interventions for complex cases that take place at the university,\u201d he said.<\/p>\n

\u201cWe see specialists from Baltic countries who are just starting their centralized endometriosis care and who need to see how we work; how outpatient clinics work; how they can do major surgeries, and the type of instruments needed. We also have colleagues from other countries including Austria, Germany, and Denmark who are very advanced but want to expand their knowledge on specific surgeries.\u201d\u00a0<\/p>\n

For example, last year Semmelweis University\u2019s endometriosis center provided surgical training on severe endometriosis that affects the colon, which is complex and requires special expertise, to gynecologists from Lithuania and Estonia, with the hope of expanding the intervention to more countries.\u00a0<\/p>\n

UK: Recognizing Centers That Meet Care Standards<\/p>\n

Although there are several expert endometriosis centers in the UK, there are calls for the expansion of multidisciplinary teams and clinical networks inside hospitals to increase management and treatment options. Currently, only 16% of hospitals that are not specialist endometriosis centers offer this.\u00a0<\/p>\n

In 2024, a National Confidential Enquiry into Patient Outcome and Death report titled \u201c Endometriosis: A Long and Painful Road<\/a>\u201c found that the disease required \u201cholistic, joined-up, multidisciplinary care.\u201d\u00a0<\/p>\n

\"photoRanee Thakar, MD<\/p>\n

\u201cWomen report better care experiences when referred to specialist centers and when they have access to specialist nurses,\u201d Ranee Thakar, MD, president of the Royal College of Obstetricians and Gynaecologists, London, told Medscape Medical News.\u00a0<\/p>\n

She added that in the hope of improving care for women with severe endometriosis, the British Society of Gynaecological Endoscopy has created a national process to recognize specialist endometriosis centers that meet certain care standards.\u00a0<\/p>\n

But, as she points out, there are more than 750,000 people currently waiting for hospital gynecology services in the UK, meaning that \u201cwomen are also finding it more difficult to see a gynecologist, further delaying their chances of a diagnosis,\u201d she added.\u00a0<\/p>\n

Better Diagnostics<\/p>\n

Experts agree that key to reducing diagnostic delays, improving the lives of patients, and reducing the need for surgical interventions is thedevelopment of affordable and reliable noninvasive diagnostics.\u00a0<\/p>\n

\u201cThis would be the ideal scenario,\u201d Bokor said. \u201cThis should either be based on blood testing or some imaging technology or a combination of these two. This could decrease the diagnostic delay to a few days or weeks.\u201d\u00a0<\/p>\n

Horace cited the recent development of a saliva test<\/a> that analyzes different microRNAs, which he said \u201cmay change the diagnosis of the disease and reduce delays.\u201d\u00a0<\/p>\n

\u201cThis saliva test opens the door to more detailed, more specific assessments of various forms of endometriosis. Using the same path, I think we can develop tests that can predict which kind of endometriosis a young woman might develop in the future, which can help us to utilize prevention methods. I think endometriosis is a disease of the 21st century, and the change in knowledge about its genetic and molecular aspects are far richer now in 2025 compared with 2000.\u201d\u00a0<\/p>\n

Bokor reported no relevant financial relationships. Vigano reported that she is the co-editor in chief of the\u00a0Journal of Endometriosis and Uterine Disorders. Roman reported receiving personal fees for surgical training and research from INTUITIVE, Johnson & Johnson, Gedeon Richter, Olympus, and IBSA.<\/p>\n","protected":false},"excerpt":{"rendered":"Endometriosis affects roughly 190 million (10%) women and girls of reproductive age globally. Still, and despite its debilitating…\n","protected":false},"author":2,"featured_media":103724,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5174],"tags":[47888,1493,35582,47890,18187,47892,47879,47889,2000,299,5187,47881,47882,47886,2207,47887,12516,47880,47883,47885,47884,2079,16,20530,15,47891],"class_list":{"0":"post-103723","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-eu","8":"tag-appendicitis","9":"tag-bacteria","10":"tag-bacterial-infection","11":"tag-bladder","12":"tag-blood","13":"tag-board-certification","14":"tag-endometriosis","15":"tag-epityphlitis","16":"tag-eu","17":"tag-europe","18":"tag-european","19":"tag-france-french","20":"tag-germany-german","21":"tag-health-related-quality-of-life","22":"tag-hospitals","23":"tag-hrqol","24":"tag-infertility","25":"tag-italy-italian","26":"tag-multidisciplinary-team","27":"tag-qol","28":"tag-quality-of-life","29":"tag-surgery","30":"tag-uk","31":"tag-uk-site-content-united-kingdom-site-content","32":"tag-united-kingdom","33":"tag-urinary-bladder"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114512316640438842","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/103723","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=103723"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/103723\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/103724"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=103723"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=103723"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=103723"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}