ANZCA Statement - Endo Articles Response
MEDIA STATEMENT
Please attribute to a spokesperson for Endo Articles
Endo Articles is aware of an ANZCA statement addressing the relationship between endometriosis lesions (Statement) and persistent pelvic pain (PPP).
About Endometriosis
Endometriosis is a chronic disease affecting approximately 1 in 7 women in Australia. It occurs when tissue similar to the uterine lining grows in other parts of the body. This can cause a wide range of symptoms, including chronic pain, fatigue, heavy menstrual bleeding, bladder and/or bowel dysfunction and infertility. In some cases, patients experience no symptoms. The economic burden of endometriosis in Australia has been placed at $9.7 billion annually.
The Statement
The ANCA statement includes the following key points:
It suggests that endometriosis lesions are not directly responsible for PPP, citing that up to 45% of individuals with endometriosis do not experience pain.
It notes that 40-60% of those with PPP have endometriosis lesions.
It indicates that surgical treatment of endometriosis lesions has not been shown to reliably improve pain and may sometimes worsen outcomes.
It notes that a diagnosis of endometriosis (presumably through surgery) has not been proven to enhance clinical outcomes for PPP.
It advocates for a shift from focusing solely on surgical interventions to a comprehensive, multidimensional approach to managing PPP.
It proposes that PPP should be treated as a type of persistent pain state requiring early, holistic and individualised care, rather than focusing exclusively on endometriosis pathology.
Endo Articles Response
Endo Articles is not a research body and cannot evaluate the accuracy of the Statement. However, we recognise that endometriosis lesions have been linked to pain through various mechanisms, including and not limited to:
Involvement with nerves;
Adhesions between organs;
Inflammatory responses; and
Aggravation of the central nervous system.
We agree that endometriosis is not the sole cause of PPP and that some people with endometriosis do not experience pain. We do not believe these points should be used to deny patients the option of surgery in favour of a “whole-person” approach.
BACKGROUND (not for attribution)
Endo Articles supports a comprehensive, whole-person, multidimensional, sociopsychobiomedical manner, as outlined in the Statement. Nonetheless, this approach should not exclude the possibility of surgical intervention for patients who choose it. It is also crucial for medical practitioners to receive adequate training in endometriosis surgical techniques and for patients to have access to all appropriate treatment options.
Our organisation is guided by the real-life experiences shared by patients, many of which were presented in our submission to the Victorian Inquiry into Women's Pain. These experiences emphasise the persistent pain experienced by a vast majority of endometriosis patients, as well as the importance of respecting patient autonomy and the right of the patient to make informed choices about their treatment. Denying surgical options risks undermining and invalidating these personal experiences as well as possibly increasing the progression and/or damage of the disease.
Endo Articles firmly believes that patients who are fully informed and consent to surgical interventions should have the right to pursue this treatment. This treatment should be offered alongside and as part of a whole-person approach to endometriosis. To do otherwise would dismiss the experiences and choices of patients, which we do not believe to be acceptable.