Ovarian preservation at hysterectomy for endometriosis

Traditionally, definitive treatment for symptomatic endometriosis has been total abdominal hysterectomy with bilateral salpingo-oophorectomy. However, aggressive excision of all endometriotic implants at the time of hysterectomy with preservation of one or both ovaries may be an acceptable alternative. All hysterectomies performed between 1988 and 1993 were retrospectively reviewed. Fifty-two women underwent laparoscopic hysterectomy for pelvic pain from advanced stage endometriosis with preservation of at least one ovary. The majority of women had significant to total relief of pelvic pain postoperatively. Average follow-up was 36 months. This series suggests that ovarian preservation at the time of hysterectomy can be considered in women with endometriosis. Patient benefits include avoidance of symptoms of surgical castration and subsequent exogenous hormone replacement.