Advances in treatment options of endometriosis

Ozkan S, Sebiha Ozkan, Sebiha Özkan, Arici A, Aydin Arici, Aydın Arıcı
Gynecologic and obstetric investigation · 2008 · vol. 67(2) , pp. 81–91 · doi:10.1159/000163071 · PMID:18931504 · W2005458011
Review OA: closed CC0 ⤵ 38 in-corpus citations
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This review discusses individualized treatment options for endometriosis-associated pain and infertility, noting medical therapy's efficacy for pain, surgery's benefit for infertility, and the need for further trials on combination therapies and etiopathogenesis.

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Abstract

Endometriosis, defined as the presence of endometrial tissue outside the uterus, is a challenging condition associated with substantial morbidity. Management of endometriosis must be individualized according to the desired treatment outcome, whether it is relief of pain, improvement of fertility, or the prevention of recurrence. For alleviation of endometriosis-associated pain, medical treatment is generally successful, with no medical agent being more efficacious than another in spite of significantly differing side-effect profiles. Surgical therapy has also been demonstrated to reduce pain scores in comparison with expectant management, although conservative surgery has been frequently associated with recurrence. The efficacy of combination therapies still remains to be clarified. For treatment of endometriosis-associated infertility, suppressive medical treatment has been proven to be detrimental to fertility and should be discouraged, while surgery is probably efficacious for all stages. Controlled ovarian hyperstimulation with intrauterine insemination is recommended in early-stage and surgically corrected endometriosis. Combined surgery with GnRH analog treatment has been proposed to be first-line therapy, followed by IVF as second-line therapy in advanced cases. More rigorously designed randomized clinical trials focusing on the endocrinological, immunological, and genetic aspects of endometriosis are necessary to refine conclusions regarding the etiopathogenesis and therapeutic innovations of this perplexing disease.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Infertility, Female Pelvic Pain Adult Adult Combined Modality Therapy Combined Modality Therapy Drug Therapy, Combination Drug Therapy, Combination Endometriosis Endometriosis Endometriosis Endometriosis Evidence-Based Medicine Evidence-Based Medicine Female Female Forecasting Forecasting Gynecologic Surgical Procedures

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (82)

Cited by (40)

Source provenance

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License: CC0 · commercial use OK