The outcomes of repeat surgery for recurrent symptomatic endometriosis

Nicola Berlanda, Paolo Vercellini, Luigi Fedele
Current opinion in obstetrics & gynecology · 2010 · vol. 22(4) , pp. 320–325 · doi:10.1097/gco.0b013e32833bea15 · PMID:20543689 · W2070294288
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Repeat conservative surgery for recurrent endometriosis yields similar pain relief to primary surgery but significantly reduces pregnancy rates, while hysterectomy offers satisfactory pain relief with a lower risk of further surgery if ovaries are removed.

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Abstract

PURPOSE OF REVIEW: To evaluate the efficacy of second-line surgery in the management of recurrent endometriosis. RECENT FINDINGS: Long-term probability of pain recurrence after repeat conservative surgery for recurrent endometriosis varies between 20 and 40%. The association of presacral neurectomy to the treatment of endometriosis might be effective in reducing midline pain; however, no studies have evaluated this procedure among patients with recurrent disease. The medium-term outcome of hysterectomy for endometriosis-associated pain is quite satisfactory; nevertheless, probability of pain persistence after hysterectomy is 15% and risk of pain worsening 3-5%, with a six times higher risk of further surgery in patients with ovarian preservation as compared to ovarian removal. The conception rate among women undergoing repetitive surgery for recurrent endometriosis associated with infertility is 26%, whereas the overall crude pregnancy rate after a primary procedure is 41%. SUMMARY: Repeat conservative surgery for pelvic pain associated with recurrent endometriosis has the same efficacy and limitations as primary surgery. Conversely, after repeat conservative surgery for infertility, the pregnancy rate is almost half the rate obtained after primary surgery. More data are needed to define the best therapeutic option in women with recurrent endometriosis, in terms of pain relief, pregnancy rate and patient compliance.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Endometriosis Gynecologic Surgical Procedures Infertility, Female Endometriosis Endometriosis Female Gynecologic Surgical Procedures Humans Infertility, Female Infertility, Female Laparoscopy Laparoscopy Recurrence Reoperation Treatment Outcome

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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.

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Cited by (50)

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