Diagnostic and therapeutic laparoscopy in the management of endometriosis

Sujata Swain, Paresh Kumar Jena
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2018 · vol. 7(11) , pp. 4695 · doi:10.18203/2320-1770.ijrcog20184532 · W2898418231
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This study evaluated 52 women with suspected endometriosis, finding dysmenorrhea and infertility were common, while laparoscopy revealed endometriomas and Stage II disease, with cystectomy being the most frequent surgical treatment.

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This paper evaluated 52 reproductive-age patients with suspected endometriosis using clinical assessment, biochemical testing, radiological imaging, and laparoscopic examination to identify abnormalities and to guide treatment. Dysmenorrhea was the most common complaint (67.6%), infertility occurred in 20%, and diagnostic laparoscopy found ovarian endometrioma in 67.3% with stage II endometriosis most frequent (46.2%). The most common therapeutic intervention was laparoscopic ovarian cystectomy (51.9%), performed as unilateral cystectomy in 40.4% of cases. The authors present these findings as concluding that laparoscopy is a standard diagnostic and therapeutic tool, though the abstract does not specify outcomes or limitations beyond the small sample size. This paper is centrally about endometriosis — it investigates diagnostic and therapeutic laparoscopy findings and procedures in endometriosis patients.

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Abstract

Background: Endometriosis associated with a variety of symptoms, primarily produces dysmenorrhea and infertility. Three classes of techniques have been used to diagnose women with endometriosis beside the history and the clinical picture: biochemical markers, radiological imaging and laparoscopic examination of peritoneal cavity.Methods: All 52 patients were evaluated clinically, biochemically, and radiologically and laparascopically to find out the abnormalities.Results: Most common complaint in a patient with endometriosis is dysmenorrhea affecting 67.6% population in this study group. 20% patients presented with infertility. Diagnostic laparoscopy of the patients in the study group show ovarian endometrioma in 67.3% population. Stage II endometriosis was seen in maximum number of cases in the study group comprising 46.2% patients. Ovarian cystectomy was the most common therapeutic procedure done in 51.9% of patients, out of which 40.4% cases treated with unilateral cystectomy and rest by bilateral cystectomy.Conclusions: This study concludes that endometriosis predominantly affects the women of reproductive age group and causes dysmenorrhea and infertility in majority of the patients. A laparoscopic finding marks as a standard tool in diagnosis and treatment of endometriosis.
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Background

Endometriosis associated with a variety of symptoms, primarily produces dysmenorrhea and infertility. Three classes of techniques have been used to diagnose women with endometriosis beside the history and the clinical picture: biochemical markers, radiological imaging and laparoscopic examination of peritoneal cavity.

Methods

All 52 patients were evaluated clinically, biochemically, and radiologically and laparascopically to find out the abnormalities.

Results

Most common complaint in a patient with endometriosis is dysmenorrhea affecting 67.6% population in this study group. 20% patients presented with infertility. Diagnostic laparoscopy of the patients in the study group show ovarian endometrioma in 67.3% population. Stage II endometriosis was seen in maximum number of cases in the study group comprising 46.2% patients. Ovarian cystectomy was the most common therapeutic procedure done in 51.9% of patients, out of which 40.4% cases treated with unilateral cystectomy and rest by bilateral cystectomy.

Conclusions

This study concludes that endometriosis predominantly affects the women of reproductive age group and causes dysmenorrhea and infertility in majority of the patients. A laparoscopic finding marks as a standard tool in diagnosis and treatment of endometriosis. Metrics

References

Andrew S. Cook. Pathophysiology of endometriosis-associated infertility. Clin Obstet Gynecol. 2017;42(3):586-610. Healey M, Ang WC and Cheng C. Surgical treatment of endometriosis: a prospective randomized double blinded trial comparing excision and ablation. Fertil Steril. 2010;94(7):2536-40. Hart RJ, Hickey M, Maouris P and Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev 2008(2). Rajeswari M, Ramanidevi T, Kadalmani B. Cohort study of endometriosis in south Indian district. Int J Reprod Contracept Obstet Gynecol. 2016;5(11):3883-8. Sahu L, Tempe A. Laparoscopic management of endometriosis in infertile women and outcome. Int J Reprod Contracept Obstet Gynecol. 2016;2(2):177-81. Arumugam K, Lim JM. Menstrual characteristics associated with endometriosis. BJOG: An International Journal of Obstetrics and Gynaecology. 1997 Aug;104(8):948-50. Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362(25):2389-98. Mishra VV, Gaddagi RA, Aggarwal R, Choudhary S, Sharma U, Patel U. Prevalence; characteristics and management of endometriosis amongst infertile women: a one-year retrospective study. J Clinic Diagnos Res: JCDR. 2015;9(6):QC01. Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril. 1991;55(4):759-65. Matalliotakis IM, Goumenou AG, Matalliotakis M, Arici A. Uterine anomalies in women with endometriosis. J Endomet. 2010;2(4):213-7. Davil GW, Estape R. Gynecologic laparoscopy surgical oncology. Clinic North Am. 2001;10(3):557-70.

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Condition tags

endometriosisendometriomadysmenorrheainfertility

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.

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