Surgical exploration as the primary modality of treatment

Endometriosis is characterized by the presence of tissue resembling endometrium in sites other than the uterine cavity. Endometriosis presents as three different entities that are usually found together—peritoneal lesions, deep endometriosis, and endometrioma. Management options include medical, expectant, and surgical options, which depend on symptoms; age; previous treatment; desire for fertility; availability, risks, and side effects of treatment options; and desires of the patient. Though surgery has long been considered as the mainstay of management, the availability of new medical options for pain relief and artificial reproductive techniques has opened up newer alternatives that can be individualized. Although surgery aims at removing the endometrial tissue for histopathological confirmation and helps alleviate pain, the chances of recurrence, reduction of the ovarian reserve, especially in women with infertility, and the risks of surgery need careful consideration requiring good counseling and discussion with the patient.