When and how should peritoneal endometriosis be operated on in order to improve fertility rates and symptoms? The experience and outcomes of nearly 100 cases

Anna M. Dückelmann, Anna M. Dueckelmann, Eliane T. Taube, E Taube, E Abesadze, Elene Abesadze, Vito Chiàntera, V Chiantera, Jalid Sehouli, J Sehouli, S Mechsner, Sylvia Mechsner
Archives of gynecology and obstetrics · 2021 · vol. 304(1) , pp. 143–155 · doi:10.1007/s00404-021-05971-6 · PMID:33537880 · PMC8164581 · W3127406830
article OA: gold CC0 ⤵ 28 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Laparoscopic peritoneal stripping of affected tissue followed by hormonal therapy and multimodal concepts improved fertility and reduced pain and recurrence in women with peritoneal endometriosis.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This prospective database study analyzed nearly 100 symptomatic women with suspected only peritoneal endometriosis who underwent laparoscopic peritoneal stripping/peritonectomy at a single experienced center between 2014 and 2019, after about 2 months of suspended hormonal pretreatment. Procedures were standardized by one surgeon, aimed to radically excise all visible peritoneal lesions and surrounding inflamed tissue, with follow-up assessment of complications, pain, fertility outcomes, and recurrence; an explicit caveat is that follow-up was not complete (data available in 87% of cases) and re-operations occurred in a subset. Postoperatively, more than three-quarters reported pain relief, and among the one-third pursuing pregnancy, 62% became pregnant, most without assisted reproduction, with a small number requiring re-operation. This paper is centrally about endometriosis — specifically laparoscopic peritoneal stripping for symptomatic early-stage peritoneal endometriosis with reported fertility and recurrence outcomes.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

PURPOSE: To analyze the follow-up results of patients suffering from symptomatic early-stage endometriosis after a consistent laparoscopic peritoneal stripping of the altered peritoneum (peritoneal endometriosis and surrounding inflamed tissue) was performed. This type of endometriosis is resistant to medical therapy and/or impairs fertility. METHODS: Using our prospectively maintained database, we were able to identify all symptomatic women with the suspicion of only peritoneal endometriosis who underwent laparoscopy at our endometriosis center over a period of 5 years. All procedures were carried out in a standardized fashion by one single surgeon, who is highly experienced in minimal invasive surgery, and included a suspended hormonal pretreatment for 2 months. Postoperative outcomes including complications, fertility and recurrence rates were analysed. RESULTS: Laparoscopic peritonectomy was performed on 94 women. Follow-up data were available in 87% of these cases. At the time of surgery, almost all patients tested showed signs of stage I or II endometriosis (44.7 and 48.9%, respectively). More than three-quarters of the women reported pain relief, inter alia, due to the post-surgical hormonal therapy. About one-third of the patients wanted to have children after the procedure. 62% of them became pregnant and the majority did so without the need for assisted reproductive therapy. In seven women a re-operation was performed. CONCLUSION: According to our data, a consistent excision of altered peritoneum followed by adjuvant hormonal therapy and multimodal concepts results in better outcomes for the patient, particularly in regards to pregnancy and recurrence rates.

My notes (saved in your browser only)

Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Infertility, Female Laparoscopy Pelvic Pain Peritoneal Diseases Adult Birth Rate Endometriosis Endometriosis Female Fertility Humans Infertility, Female Infertility, Female Laparoscopy Laparoscopy Pelvic Pain Peritoneal Diseases Peritoneal Diseases Peritoneum

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (75)

Cited by (28)

Source provenance

europepmc
last seen: 2026-06-12T06:13:51.797165+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:24:55.077982+00:00
License: CC0 · commercial use OK