Endometriosis: When and How We Treat

Sidonia Maria Saceanu, Ștefan Pătrașcu, Anca Pătraşcu, Valeriu Surlin
In: Fertility-oriented Female Reproductive Surgery · 2017 · doi:10.5772/65296 · W2577314838
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This chapter updates endometriosis management, discussing surgical benefits and drawbacks, with laparoscopy as the gold standard for endometrioma and potentially the stripping technique for pain relief at the risk of ovarian reserve.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This paper reviews the management of endometriosis, focusing on surgical options for endometrioma and other lesions, based on a systematic PubMed search (English literature, 2010–2014) prioritizing meta-analyses, randomized trials, and cohort studies. It reports that operative laparoscopy is described as a gold standard for endometrioma treatment, with stripping and electro-coagulation as key techniques, and notes that stripping may reduce recurrence of pain and reoperation rates while raising concerns about ovarian reserve. The chapter also contrasts conservative versus radical surgery, emphasizes that the primary evidence-supported surgical benefit is pelvic pain relief, and highlights that hormonal adjuncts perioperatively have not shown statistically significant effects on recurrence, pain, morbidity, or pregnancy rates. This paper is centrally about endometriosis — it provides an update of how endometriosis is treated, emphasizing the benefits and disadvantages of surgical methods.

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Abstract

Endometriosis is a chronic, nonmalignant and estrogen‐dependent disease in which endometrial glandular epithelium and stroma are outside the uterine cavity (ovaries, peritoneum, or rectovaginal septum). The prevalence is estimated from 2 to 10% in women of childbearing age and it rises up to 50% in women with infertility. Despite maximal efforts, the therapy of first choice in the management of endometriosis is still unclear. The aim of this chapter is to present an update of its management, emphasizing the benefits and disadvantages of surgical methods. We performed a systematic literature search on the PubMed database of English literature (search terms: endometrioma, surgery, ovarian reserve, assisted reproductive technologies) from 2010 to 2014. For endometrioma, operative laparoscopy proved to be the gold standard. Surgical procedures consist of partial excision of the cyst wall and electro‐coagulation of the rest. Stripping technique may be a better method for reducing the recurrence of pain symptoms, recurrence, and reoperation rates, but it raises concerns about ovarian reserve. For endometriosis, surgery often includes partial rectum or sacrouterine ligament resection. Hysterectomy is not obligatory and refused by the young patients. The approach should be laparoscopic and if necessary vaginal assisted. Good cooperation between various disciplines (gynecology, surgery, urology) is mandatory.

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Condition tags

endometriosisendometriomainfertility

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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