[Surgical management of endometriosis].

Abstract

Both laparoscopic techniques (excision and ablation) for the treatment of superficial peritoneal endometriosis are equally effective (EL2). For the treatment of ovarian endometriomas larger than 3 cm, laparoscopic cystectomy is superior to drainage and coagulation (EL1). Excision of deep rectovaginal endometriosis with or without rectal invasion significantly reduces endometriosis-associated pain (EL4). Laparoscopic partial bladder cystectomy is easier for dome endometriosis than vesical base lesions (EL4). Hysterectomy with ovarian conservation is associated with a high risk of pain recurrence (EL4). Despite bilateral oophorectomy, pain recurrence can occur with hormonal treatment (EL2). Rates of major (ureteral, vesical, intestinal or vascular) complications of endometriosis surgery range from 0.1 to 15% of patients. Higher rates are more common with deep endometriosis surgery (EL2). Patients should be aware of these specific major complications. It is advisable to explain that pain improves, either partially or completely, in about 80% of patients.

• Authors: F Golfier, M Sabra
• Journal: Journal de gynecologie, obstetrique et biologie de la reproduction (J Gynecol Obstet Biol Reprod (Paris)) Vol. 36 Issue 2 Pg. 162-72 (Apr 2007) ISSN: 0368-2315 [Print] France
• Vernacular Title: Prise en charge chirurgicale de l'endométriose.
• PMID: 17267134 (Publication Type: English Abstract, Journal Article, Review)

Topics

• Endometriosis (surgery)
• Female
• Humans
• Hysterectomy
• Laparoscopy (methods)
• Ovariectomy
• Pelvic Pain (epidemiology, etiology)
• Postoperative Complications (epidemiology)
• Treatment Outcome