Clinical management of endometriosis

Falcone T, Tommaso Falcone, Dan I. Lebovic
Obstetrics and gynecology · 2011 · vol. 118(3) , pp. 691–705 · doi:10.1097/aog.0b013e31822adfd1 · PMID:21860303 · W2332643287
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This article reviews surgical and medical management strategies for endometriosis, addressing diagnosis, infertility, chronic pain, cancer risk, and postmenopausal hormone therapy.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-13 · read from full text ⓘ

This review article examines the clinical management of endometriosis, a chronic gynecologic disorder characterized by pelvic pain and infertility. It highlights that definitive diagnosis requires surgery, while noting that medical therapy offers only short-term pain relief and does not improve fertility outside of assisted reproductive technology. The authors discuss the complexities of treating endometriomas due to potential reductions in ovarian reserve and emphasize the importance of complete surgical excision to minimize recurrence rates. This paper is centrally about endometriosis — specifically focusing on the diagnostic challenges, surgical techniques for lesion removal, and long-term management strategies for pain and disease recurrence.

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Abstract

Endometriosis is a relatively common chronic gynecologic disorder that usually presents with chronic pelvic pain or infertility. The societal effect of this disorder is enormous both in monetary costs and in quality of life. The diagnosis of the disease can only be definitively made with surgical intervention. Fertility may be enhanced with surgical intervention, but medical suppressive therapy has no role apart from in vitro fertilization. Assisted reproductive technology is associated with excellent outcomes. Management of endometriomas is particularly complex because surgical intervention may reduce ovarian reserve. Both medical and surgical treatment of endometriosis-associated chronic pelvic pain are effective in the short-term. Recurrence is common with both modalities. Recurrence after surgical intervention can be decreased with the use of postoperative suppressive medical therapy such as hormonal contraceptives. This article presents the different types of peritoneal disease found in endometriosis patients. The technique used to safely and completely remove the disease is discussed. The specific areas of involvement include the pelvic side wall, the cul-de-sac, and bladder peritoneum.
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Clinical Management of Endometriosis - Tommaso Falcone - Dan I. Lebovic Endometriosis is a relatively common chronic gynecologic disorder that usually presents with chronic pelvic pain or infertility. The societal effect of this disorder is enormous both in monetary costs and in quality of life. The diagnosis of the disease can only be definitively made with surgical intervention. Fertility may be enhanced with surgical intervention, but medical suppressive therapy has no role apart from in vitro fertilization. Assisted reproductive technology is associated with excellent outcomes. Management of endometriomas is particularly complex because surgical intervention may reduce ovarian reserve. Both medical and surgical treatment of endometriosis-associated chronic pelvic pain are effective in the short-term. Recurrence is common with both modalities. Recurrence after surgical intervention can be decreased with the use of postoperative suppressive medical therapy such as hormonal contraceptives. This article presents the different types of peritoneal disease found in endometriosis patients. The technique used to safely and completely remove the disease is discussed. The specific areas of involvement include the pelvic side wall, the cul-de-sac, and bladder peritoneum.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Adult Adult Drug Therapy, Combination Drug Therapy, Combination Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Female Female Fertilization in Vitro Fertilization in Vitro Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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Cited by (50)

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