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.