Surgical management of endometriosis

P Vercellini, Paolo Vercellini, O De Giorgi, Olga De Giorgi, A Pisacreta, Anna Pisacreta, Pisacreta A, Pesole AP, Antonella Pesole, A P Pesole, Sarah Vicentini, S Vicentini, Vicentini S, Pier Giorgio Crosignani, P. G. Crosignani, Crosignani PG
Bailliere's best practice & research. Clinical obstetrics & gynaecology · 2000 · vol. 14(3) , pp. 501–523 · doi:10.1053/beog.1999.0088 · PMID:10962639 · W3141326577
review OA: closed CC0 ⤵ 35 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This paper reviews the surgical management of endometriosis, focusing on diagnosis, techniques, and patient outcomes.

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

Abstract

A systematic literature review of the last two decades was performed to evaluate the effect of pelvic denervations in addition to conservative surgery on dysmenorrhoea and deep dyspareunia associated with endometriosis. Chronic pelvic pain relief after hysterectomy or adhesiolysis was also assessed. In the five non-comparative studies on the effect of pre-sacral neurectomy, the frequency of dysmenorrhoea recurrence or persistence after treatment ranged from 4 to 40%. The pooled frequency of non-responders at the end of follow-up was 23% (95% confidence interval (CI), 19 to 27%). Only two of the three comparative, non-randomized trials demonstrated a significant treatment benefit of pre-sacral neurectomy, and the results of the two identified randomized controlled trials are discordant. Significant quantitative heterogeneity among studies prevented pooling of data on dysmenorrhoea. The common odds ratio of deep dyspareunia persistence was 0.69 (95% CI, 0.31 to 1.54). In the 10 non-comparative studies on the effect of uterosacral ligament resection, the frequency of dysmenorrhoea and deep dyspareunia persistence after treatment ranged, respectively, from 0 to 50% and from 6 to 42%. The pooled frequency of non-responders at the end of follow-up was 23% (95% CI, 20 to 27%) and 13% (95% CI, 8 to 18%), respectively. Routine performance of complementary denervating procedures cannot be recommended based on the quality of the evidence available. The results of the five studies on the effect of hysterectomy on chronic pelvic pain of presumed uterine origin consistently demonstrated that 83-97% of operated women reported pain relief or improvement 1 year after surgery. There is no consensus on the outcome of adhesiolysis in patients with chronic pain, and the role of pelvic adhesions in causing symptoms is under scrutiny.

My notes (saved in your browser only)

Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Pelvic Pain Adult Denervation Denervation Endometriosis Endometriosis Female Genitalia, Female Genitalia, Female Humans Hysterectomy Hysterectomy Middle Aged Pelvic Pain Pelvic Pain Randomized Controlled Trials as Topic Tissue Adhesions Tissue Adhesions

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 (92)

Cited by (34)

Source provenance

europepmc
last seen: 2026-08-26T06:08:41.316361+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:13:36.046895+00:00
unpaywall
last seen: 2026-08-26T06:23:03.089193+00:00
License: CC0 · commercial use OK