Skip to Main content Skip to Navigation
Master Thesis

Connaissances et attitudes des gynécologues français envers le traitement conservateur des hyperplasies atypiques et adénocarcinomes de l’endomètre

Abstract : Introduction: the standard treatment for AH/EC is hysterectomy, which seems unacceptable in patients who still have a desire for a child. Conservative treatments for fertility preservation (FP) have been successfully developed but clear recommendations for care are still lacking. The purpose of this work is to evaluate the knowledge and attitudes of French gynaecologists regarding FP of AH/CE: gynaecological surgeons (GC) and reproductive medicine specialists (RMS). Methods: a national survey among French gynaecologists: one questionnaire with one common part and two specific parts for gynecological surgeon (GS) or for specialists in reproductive medicine (SRM) was sent from April 2017 to April 2018. Knowledge and attitudes toward FP in EC/AH were evaluated with a “knowledge score” and an “attitudes score” using a four- or five-point Likert scale. Results: one hundred forty physicians completed the survey (87 GS, 53 SRM). The knowledge score was low (59.3 % medium/low), but it was significantly higher for GS compared to SRM. The better-known treatments were oral progestins and hysteroscopic resection. Among the participants treating EC/AH, 52.6% found it “difficult” to manage patients and 61.8% regretted the lack of official recommendations. Most physicians seemed to be uncomfortable/unsupportive with FP in EC/AH (57.2% “attitude score” below 11/20). There was a positive correlation between knowledge and attitude scores. GS “usually/always” give advice to patients about FP before EC/AH treatment. After maximum 3-6 months, 56.6% of SRM chose IVF to reduce time-to-pregnancy, with GnRH antagonist protocols (28%) or mild-stimulation (15.1%) to avoid hyperoestrogenism. Conclusion: despite reassuring results in the literature, French gynecologists are uncomfortable with FP using EC/AH conservative management, which may be because of a lack of confidence in their knowledge. Specific guidelines are needed to help physicians manage these young patients and their fertility.
Document type :
Master Thesis
Complete list of metadata

https://dumas.ccsd.cnrs.fr/dumas-03206005
Contributor : Université Paris Descartes - Scd Connect in order to contact the contributor
Submitted on : Thursday, May 6, 2021 - 3:50:05 PM
Last modification on : Tuesday, September 7, 2021 - 3:23:51 AM

File

ThExe_MAUMY_Louise_DUMAS.pdf
Files produced by the author(s)

Licence


Distributed under a Creative Commons Attribution - NonCommercial - NoDerivatives 4.0 International License

Identifiers

  • HAL Id : dumas-03206005, version 1

Citation

Louise Maumy. Connaissances et attitudes des gynécologues français envers le traitement conservateur des hyperplasies atypiques et adénocarcinomes de l’endomètre. Médecine humaine et pathologie. 2019. ⟨dumas-03206005⟩

Share

Metrics

Record views

23

Files downloads

10