Scientists from the Hannover Medical School (MHH) have examined on behalf of the Institute for Quality and Economics in Health Care (IQWiG) whether there are no surgical or non -drug alternatives for the treatment of pain in endometriosis.They come to the conclusion that these procedures are not sufficiently examined and therefore no reliable statements about the advantages and disadvantages of the non-drug or non-operational procedures are possible.
However, since the results of ongoing studies are available for the next few years, the scientists commissioned will receive clearer answers in the future.
Endometriosis is one of the most common gynecological diseases
Endometriosis is a mostly benign chronic disease, in the tissue that resembles the endometrium, also occurs at places outside the uterine cavity (for example on the ovaries).The main symptom of endometriosis are abdominal pain - often in connection with the menstrual period, less often in sexual intercourse or in bowel movements.The disease occurs predominantly at childbearing age, is hormone -dependent and can reduce fertility.
It is estimated that in Germany approx..40,000 new cases occur.Around 20,000 women are instructed in Germany every year for endometriosis for hospital treatment.
Various treatments, especially with hormonal contraceptives and operations to eliminate the endometriosis focly, are well examined and can help to relieve the symptoms temporarily or permanently.Pain relievers are also used.However, many women tolerate the hormone preparations and sometimes the pain relievers, or reject them.
In addition to the established therapies, affected women often look for further treatment, among other things, to have the opportunity to actively do something against endometriosis themselves.You would also like to avoid any side effects of drug therapy or operations.In addition to medication and operations, there has therefore been no medication and non-operational treatments (NMNO procedures) for years.
Request of a citizen as the starting point of the report
The starting point of the now present HTA report was the question of a citizen asked as part of the Medicine Check whether there are promising alternatives in the treatment of endometrios-related pain if surgical methods are out of the question or are already exhausted.
In its topic proposal for this HTA report, the proposal pointed out that treatment of endometrios-related pain with hormone therapy or with painkillers if you want to have children is not possible or.is not desired.The topic proposal therefore asks what non -drug possibilities there are to reduce endometrios -related pain if the therapy with hormone preparations has been discontinued due to a desire to have children and surgical methods are out of the question or are already exhausted.
No really reliable studies
The scientists of the Hanover Medical School, commissioned by the IQWiG, could not classify any study results for the benefit and damage of NMNO procedures for endometrios-related pain as really reliable.They evaluated eleven RCTs (Randomized Controlled Trials) using various NMNO procedures.Most results showed a high potential for distortion, some of them were not usable to derive the benefit.For example, the methodological quality of the studies and the quality of the reporting in six of the eleven studies was so low that the results from the perspective of the scientists could not be interpreted or only in some cases interpreted sensibly.
However, since the results from ongoing studies stand for the next few years, the scientists hope for clearer answers for the future.
Citizens ask - scientists answer
Since 2016 it has been possible for citizens to use the themed check of medicine scientifically sound answers to certain medical questions in the form of a scientific health technology evaluation (English.Health Technology Assessment = HTA)- for example, for advantages and disadvantages of a certain form of treatment or the meaningfulness of an examination method.
One of the special features of "Theme Check Medicine" is that the questions of the reports always go back to suggestions from the population.The IQWiG collects it and selects up to five topics per year.A selection advisory board brings in the citizen and patient perspective, a specialist advisory board the expert perspective.
The HTA reports are not written by the IQWiG itself, but by commissioned external experts.Their evaluation is published together with a generally understandable short version (HTA compact) and a publisher of the IQWiG.
Suggestions for new topics are welcome and can be online at any time under Theme Check Medicine: Suggest the topic and be submitted without medical expertise.The theme check team clarifies open points, if necessary, then directly with the submitted in the telephone contact.
