ESPriT1: the effectiveness of laparoscopic treatment of isolated superficial peritoneal endometriosis for managing chronic pelvic pain in women: a randomised controlled feasibility trial

Lucy Whitaker, Linda Williams, Jacqueline Stephen J, Jane Daniels, Andrew W. Horne
In: Reproduction and Fertility · 2026 · vol. 7(2) · doi:10.1530/raf-26-0043 · PMID:42160242 · PMC13232596 · W7161755030
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This feasibility trial found that 31% of women with suspected endometriosis undergoing laparoscopy consented to participate in a randomized trial comparing surgical removal of superficial peritoneal endometriosis versus sham surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This randomised controlled feasibility trial studied whether laparoscopic treatment for isolated superficial peritoneal endometriosis could reduce chronic pelvic pain in women, using trial methods that assessed feasibility alongside clinical outcomes. The study design involved a lead site and statistical analyses performed by the trial team, with the key finding being reported as part of feasibility testing rather than definitive effectiveness. The paper explicitly frames the work as feasibility, implying limitations in power to confirm efficacy. This paper is centrally about endometriosis — it evaluates laparoscopic treatment specifically for isolated superficial peritoneal endometriosis to manage chronic pelvic pain.

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Abstract

Lay summary: Endometriosis is a chronic pain condition that affects >190 million people worldwide. It is recommended in clinical guidelines to remove the most common type of endometriosis, 'superficial peritoneal endometriosis' (SPE), if it is diagnosed at laparoscopy (keyhole surgery). However, the evidence to support removal of SPE is based on small studies with short-term follow-up. The aim of this small feasibility trial was to determine what proportion of women with pelvic pain undergoing laparoscopy for suspected endometriosis would be willing to be randomly allocated to have surgical removal of SPE or not have it treated surgically straightaway (sham surgery). Of the eligible patients that were approached, 31% consented to take part, demonstrating that people with endometriosis are willing to take part in a sham surgical trial. We are now leading a similar, but much larger UK-wide trial, to determine whether removal of SPE truly improves painful endometriosis symptoms.
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Funding

This research was funded by MRC (Grant No. MR/N022556/1) and the Chief Scientist Office (Award No. TCS/18/43).

Coi Statement

LHRW received grant funding from the NIHR, UKRI, Chief Scientist’s Office and Wellbeing of Women. LHRW’s institution received grant funding from Roche Diagnostics and honoraria for teaching from Gedeon Richter and Theramex. JPD received grant funding from the NIHR, Chief Scientist’s Office and Wellbeing of Women. AWH received grant funding from the NIHR, MRC, Chief Scientist’s Office, Wellcome Trust, Wellbeing of Women, Ferring and Roche. AWH’s institution received honoraria for consultancy from Roche Diagnostics, Gesynta and Joii; grant funding from Roche Diagnostics; and honoraria for teaching from Gedeon Richter. AWH has received lecture fees from Theramex. The other authors declare no competing interests. A W Horne is co-Editor-in-Chief of Reproduction & Fertility and was not involved in the review or editorial process for this paper, on which he is listed as an author.

Author Contributions

All authors contributed to the conception, design and delivery of the study. AWH and JPD secured funding. AWH, LHRW, JPD, JS and LJW were the trial management group. LHRW was PI for the lead site. JS and LJW performed the statistical analyses. LHRW, LJW, JS and AWH drafted the report, and all authors provided input to editing for publication and accept responsibility to submit for publication.

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Outcome instruments

EHP-30

Condition tags

endometriosischronic_pelvic_pain

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