Surgical Management of Pain and Infertility Secondary to Endometriosis

The management of pain and infertility secondary to endometriosis remains a challenge. Surgical management of early-stage endometriosis-associated infertility has only a mild effect with a number needed to treat of at least 12 to achieve one pregnancy. Excision of endometriomas provides the best outcome for fertility and pain; however, there is a potential to reduce the ovarian reserve. Pain relief is seen in most patients undergoing surgical management but with a high recurrence rate over time. Long-term postoperative medical suppressive therapy with oral contraceptives may have some benefit in reducing recurrence of symptoms. Hysterectomy is effective in the long-term management of chronic pain associated with endometriosis.

Endometriosis - surgery - laparoscopy

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Fertil Steril. 2007; 88 (5) 1413-1426 Tommaso FalconeM.D. Department of Obstetrics and Gynecology, Desk A-81, Cleveland Clinic 9500 Euclid Avenue, Cleveland, OH 44195 Email: [email protected]