Table I.

Questions formulated by the chairpersons of each workshop before the meeting. The individual experience is the number of women with endometriosis treated, or the ‘years of practice’ times ‘the number of endometriosis patients treated/year’. The total experience (TE) is the sum of the individual experience. The approval rate (%) by those with an individual experience of more than 50 women is the sum of their individual experiences approving (defined as ≥ 8/10 VAS) over their total experience. The approval rate (%) thus gives more weight to those with more experience. Questions judged experience-based are indicated in red, knowledge-based in white, and ambiguous or political in blue.

	%	TE
Adolescence
If after 3 months of medical therapy for pain, pain or dysmenorrhoea is still 3/10 I do a laparoscopy	22	8976
Do you think endometriosis can grow significantly during medical therapy	29	8976
A delay in diagnosis of more than 5 years results in more severe endometriosis lesions	64	8766
Fertility
I consider and discuss oocyte preservation, before surgery for severe endometriosis in a 30-year-old woman planning a pregnancy.	63	9224
I think the presence of deep endometriosis decreases the success rate of IVF.	60	9336
In young infertile women without pain and no other infertility factors, including the husband, laparoscopy should be done before starting IVF	34	9336
Controlled ovarian stimulation accelerates the growth of endometriosis	28	9336
The presence of a recto-vaginal nodule of 2cm is a contra-indication for IVF	12	9232
Classification
Which classifications do you use regularly for endometriosis? (tick as many answers as you can)	see text
The Enzian/#Enzian classification reflect accurately the difficulty of surgery	56	8580
The Enzian/#Enzian classification correlates well with the symptoms of the patient	23	8680
The rASRM classification reflect accurately the difficulty of surgery	5	8524
The rASRM classification correlates well with the symptoms of the patient	4	8524
The AAGL classification correlates well with the symptoms of the patient	11	7118
We need a classification of non-invasive diagnosis	74	8840
An endometriosis classification is useful for IVF treatment	40	8958
Adenomyosis
In infertile women, a thickened junctional zone needs medical management	31	9011
When adenomyosis is suspected on ultrasound, MRI is needed before surgery	35	9336
If infertility and an adenomyosis nodule of >1cm, I do surgery	89	9252
A classification system for adenomyosis is useful for clinical management	54	8965
Infertility of >5 years and only adenomyosis: I expect the fertility rate after surgery (%)	see text
For severe diffuse adenomyosis, the complete removal of the longitudinal muscle layer of the myometrium (neometra) is safe if the patient wishes to become pregnant.	4	9252
Sub-endometrial adenomyotic cysts of < 1cm should be treated via hysteroscopy	56	9272
Imaging
My decision to do a bowel resection is based on ultrasound and or MRI imaging	45	8681
A descriptive imaging report has more value than a classification system	53	9230
Ultrasound imaging accurately predicts ureter involvement even without hydronephrosis	31	9162
In women with cystic ovarian endometriosis larger than 3cm, the ovarian reserve needs to be evaluated e.g. by an antral follicle count (AFC)	70	9129
In adolescents, transabdominal ultrasound can replace transvaginal or transrectal ultrasound	14	9186
Has MRI added value for rectal endometriosis compared with an expert transvaginal ultrasound?	19	9336
An endometrioma of 4cm AND CA125 = 50: from what age do you do an adnexectomy	see text
How do you describe the size of deep endometriosis?	see text
Bowel stenosis of the rectum can be diagnosed reliably by ultrasound.	23	9240
Depth of infiltration in the bowel wall can be diagnosed reliably by ultrasound	51	8970
The bowel
In deep endometriosis, should we excise fibrosis or can we leave it?	54	9177
Is it better to do a double discoid excision (if feasible) over a bowel resection	51	8517
Do you use omental flaps to protect the bowel or ureter after re-anastomosis?	25	8526
Should the type of surgical intervention be decided before surgery (versus during surgery)	47	8967
Do you use daily C reactive protein (CRP) after surgery for deep endometriosis?	52	8429
Should asymptomatic women with a 2*2*2cm bowel nodule be operated on?	7	9113
The ureter
Ultrasound is an appropriate imaging modality to diagnose hydronephrosis.	90	9240
If hydronephrosis is present, I order a functional assessment of the kidney before surgery.	87	9240
A kidney is considered irrecuperable if renal function is below ..... %	see text
I am comfortable placing ureteral stents without the assistance of a urologist.	36	8421
Before extensive ureterolysis without hydronephrosis, a ureteral stent is indicated.	32	8652
For how many years do you check for ureter stenosis after reanastomosis	see text
The right surgeon for each patent
The future of endometriosis surgery will be a pelvic surgeon (versus a multidisciplinary team )	44	9336
A thin-walled hydrosalpinx should be operated by salpingostomy (versus a salpingectomy).	0	8344
I ask a colorectal surgeon for help to do a bowel resection of the sigmoid.	77	8638
I ask a colorectal surgeon for help to do a bowel resection of the low rectum.	84	8638
My colorectal surgeon agrees that endometriosis requires less extensive surgery than cancer and that a colostomy or ileostomy is not needed	61	8352
I manage my postoperative bowel complication without the assistance of a colorectal surgeon	13	8515
I manage my postoperative ureter complications without the assistance of a urologist	21	8638
I do all ureter surgery without the help of a urologist	34	8638
Sacral root surgery requires the assistance of a neurosurgeon	24	8171
Fertility surgery requires specific training besides severe endometriosis training	62	9049
An endometriosis referral surgeon should operate more than ....... cases a year with bowel, bladder or ureter involvement	see text/fig
Patient-centered outcomes
Negative findings during clinical exam and imaging (ultrasound and/or MRI) do not rule out endometriosis	88	9273
Negative findings during laparoscopy do not rule out endometriosis	52	9273
A diagnosis of endometriosis validates symptoms and provides access to relevant care	80	9016
All decisions on endometriosis management should be made together with the patient	93	9273
Educational programs should be added to school curriculums to understand a normal period and menstrual well-being.	91	9273
National healthcare systems should care for and meet the needs of those with endometriosis to receive high-quality and holistic care.	89	9273
Those with endometriosis should be supported to succeed in employment through appropriate adaptions and workplace policies	73	9196
Those living with endometriosis should be involved in setting priorities for endometriosis research and contribute to protocol development	78	9066
Adhesion prevention
Incomplete endometriosis excision causes more adhesions	53	9336
Barriers should be used systematically after endometriosis surgery	40	8916
I estimate that barriers decrease postoperative adhesions by .....(%)	see text
After excision of cystic ovarian endometriosis, adhesions occur in (%)	see text
Cystic ovarian endometriosis
What size endometrioma in a 25-year-old patient with little pain requires surgery	Fig 1
The capsula of an endometrioma is fibrosis and not endometriosis	40	8916
Tick sequentially your first and second choice to treat endometriomas of 7-8 cm in a 25-nulliparous patient	see text
Tick sequentially your first and second choice to treat endometriomas of 3-4 cm in a 25-nulliparous patient	see text
What is your preferred method to achieve hemostasis after excision?	see text
Femtech AI
All laparoscopic diagnoses of endometriosis must be confirmed by pathology	40	8916
An app would improve the follow-up after medical or surgical treatment of endometriosis	60	9124
An app would improve the diagnosis of endometriosis	49	8629
Indocyanine green should be used to check vascularisation after bowel resection-anastomosis	33	8251
Indocyanine green should be used to check vascularisation after ureter resection-anastomosis	39	8121
For the excision of deep endometriosis with hydronephrosis, robotic surgery is superior	15	8505
Nerves
Severe menstrual sciatalgia with a normal MRI needs a surgical exploration of the sciatic nerve	24	8103
An image of the dermatomes should be used in the medical records	56	8210
The surgeon needs to know the dermatomes of The genito-femoral nerve	77	7998
The ilio inguinal nerve	80	7536
The ilio hypogastric nerve	82	7788
The sciatic nerve	85	7998
Pain
Deep endometriosis without pain or dyspareunia decreases libido	14	9084
Chronic pelvic pain without dyspareunia decreases libido	72	9084
Centralization of chronic pain occurs after how many months?	see text
Pain reduction after surgery should be judged after how many months?	see text
The memory of pain makes the pain worse when there is a recurrence of endometriosis.	68	9277
Sexuality	####	0
When suspected or confirmed endometriosis, should we ask about deep dyspareunia	96	9093
When suspected or confirmed endometriosis, should we ask about comorbid bladder symptoms, “the evil twins” (post-coital/recurrent cystitis, urinary urgency and/or frequency?)	90	9093
When suspected or confirmed endometriosis, should we ask about vulvar pain and/or introital dyspareunia?	77	8937
Do you use a validated questionnaire (e.g. FSFI -Female Sexual Functioning Index) to judge the impact of endometriosis on sexual function	15	8799
When suspected or confirmed endometriosis, do you ask about the sexuality of the couple including the partner	58	9093
Medical therapy
During medical treatment, I do a 6 or 12-monthly ultrasonographic follow-up	72	9336
In adolescents with dysmenorrhoea >7/10 and negative exams, I start medical treatment	86	9336
I use medical treatment before surgery for deep endometriosis	38	9336
I use medical treatment before surgery for cystic ovarian endometriosis	30	9240
After endometriosis surgery, I give medical therapy without menstruation until pregnancy wish	12	8849
I estimate the placebo effect of medical treatment for pelvic pain at	see text