Endometriosis and laparoscopic surgery

• laparoscopic surgery can relieve symptoms of dysmenorrhoea, dyspareunia and pelvic pain associated with endometriosis. There is no reliable evidence to currently suggest whether surgical treatment is better, or worse, than medical treatment for endometriosis related pain.
  
  
• laparoscopic surgery may improve fertility in cases of endometriosis. A randomised controlled trial investigated laparoscopic surgery (surgical resection or laser ablation) in women undergoing diagnostic laparoscopy for infertility and who were found to have mild or minimal endometriosis.
  • 31% of women who had had surgical destruction of endometriosis became pregnant within 9 months
  • 18% of control group who only underwent diagnostic laparoscopy became pregnant
  • the trial is controversial because the women were told which treatment they had received and this could have affected the blinding of the trial

There is evidence that combined laparoscopic ablation of endometrial deposits and uterine nerve is likely to be a beneficial intervention the management of endometriosis (2).

Reference:

1. New England Journal of Medicine 1997; 337:217-22.
2. Clinical Evidence (March 2005). Endometriosis