Fertility considerations in laparoscopic treatment of infiltrative bowel endometriosis.

Catherine Mohr, Farr R Nezhat, Farr Nezhat, Ceana Nezhat, Ceana H Nezhat, Daniel S Seidman, Camran Nezhat, Camran R Nezhat
JSLS : Journal of the Society of Laparoendoscopic Surgeons · 2005 · vol. 9(1) , pp. 16–24 · PMID:15791964 · PMC3015563 · W2410863482
article OA: gold CC0 ⤵ 89 in-corpus citations
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Laparoscopic surgery for bowel endometriosis prioritizing fertility goals achieved significant pain relief and a 34% pregnancy rate in infertile patients, with shaving offering lower complication rates than disc excision or segmental resection.

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Abstract

OBJECTIVE: The purpose of this study was to examine our experience with laparoscopic and laparoscopically assisted management of bowel endometriosis and to recommend treatment approaches, considering patient goals for both pain mitigation or fertility, or both. METHODS: The medical records of 187 women treated laparoscopically for intestinal endometriosis were reviewed retrospectively for presenting symptoms, methods of surgical treatment, complications, and efficacy of treating pain and infertility. The extent of resection was determined by the severity of the endometriotic lesion, tempered by the patient's fertility goals. RESULTS: The most common patient complaint preceding surgery was pelvic pain. In addition, 58 (31%) patients experienced impaired fertility. Of the patients available for long-term follow-up, 152 (85%) reported complete or significant long-term pain relief. Complete pain relief in the immediate postoperative period was significantly more likely with partial bowel resection compared with shaving only, 92% vs 80%, respectively, P<0.04. The least invasive procedure, shaving, was associated with a significantly lower complication rate, 6%, compared with 23% for disc excision (P<0.007) and 38% for segmental resection (P<0.001), and higher pregnancy rates. The incidence of pregnancy in patients with a history of infertility was 34% during the follow-up period.

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Condition tags

endometriosisbowel_endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Intestinal Diseases Laparoscopy Laparoscopy Laparoscopy Adult Endometriosis Endometriosis Female Humans Infertility, Female Intestinal Diseases Intestinal Diseases Middle Aged Retrospective Studies

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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.

References (19)

Cited by (50)

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