Surgical Treatment of Endometriosis

George Michalopoulos, Giorgos D. Michalopoulos, Vassilios Makris, Aris Daniilidis, Chrysanthi Sardeli, Konstantinos Dinas, C Giannoulis, Panagiotis Dimitrios Loufopoulos
In: Current Women's Health Reviews · 2012 · vol. 8(2) , pp. 131–137 · doi:10.2174/157340412800194911 · W2312988790
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This systematic review of surgical endometriosis treatments found that excisional methods offer better outcomes than ablation for pain relief, recurrence, symptom control, and fertility, with ancillary procedures and hysterectomy serving specific roles.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

This paper is a systematic review of literature on surgical treatment of endometriosis, emphasizing studies published since 2000, using searches of Medline/MeSH/Cochrane for terms related to excision, ablation, denervation, pelvic pain, and infertility. It assessed short-, medium-, and longer-term efficacy across surgical modalities, including 53 articles in the final review out of 114 considered, with the stated limitation that pre-2000 and small trials were only included if commonly referenced. The review concludes that excisional treatment is associated with more favourable outcomes than drainage and ablation regarding pain relief, endometrioma recurrence, symptom control, and fertility rates, and notes that ancillary procedures like presacral neurectomy and laparoscopic uterine nerve ablation can help with dysmenorrhea, while the role of medical treatment remains unclear. This paper is centrally about endometriosis — it systematically evaluates surgical approaches and their outcomes.

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Abstract

Objective: We review the surgical modalities used in the treatment of endometriosis, including ablative, excisional and denervating. Design: A systematic review of the literature referring to the surgical treatment of endometriosis with emphasis on articles published since 2000. Data sources: Medline, MeSH and Cochrane library searches for terms including “endometriosis”, “ablation”, “excision”, “denervation”, “pelvic pain” and “infertility”. Eligibility criteria: Trials assessing the short, medium and longer-term efficacy of surgical modalities employed in the treatment of endometriosis were considered. Studies published prior to 2000 and small power trials were included only if commonly referenced in the literature. Results: 114 articles were considered with 53 referenced in the final review. Conclusions: Excisional treatment provides more favourable outcomes than drainage and ablation with regards to pain relief, endometrioma recurrence, symptom control and fertility rates. Ancillary surgical procedures such as presacral neurectomy and laparoscopic uterine nerve ablation can prove helpful in the management of dysmenorrhoea. Radical surgery in the form of hysterectomy remains end-stage treatment for endometriosis. The role of medical treatment remains unclear. Keywords: Ablative, denervating, endometriosis, excisional, laparoscopy, laparotomy
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Abstract

Design: A systematic review of the literature referring to the surgical treatment of endometriosis with emphasis on articles published since 2000. Data sources: Medline, MeSH and Cochrane library searches for terms including “endometriosis”, “ablation”, “excision”, “denervation”, “pelvic pain” and “infertility”. Eligibility criteria: Trials assessing the short, medium and longer-term efficacy of surgical modalities employed in the treatment of endometriosis were considered. Studies published prior to 2000 and small power trials were included only if commonly referenced in the literature.

Results

114 articles were considered with 53 referenced in the final review.

Conclusions

Excisional treatment provides more favourable outcomes than drainage and ablation with regards to pain relief, endometrioma recurrence, symptom control and fertility rates. Ancillary surgical procedures such as presacral neurectomy and laparoscopic uterine nerve ablation can prove helpful in the management of dysmenorrhoea. Radical surgery in the form of hysterectomy remains end-stage treatment for endometriosis. The role of medical treatment remains unclear.

Keywords

Ablative, denervating, endometriosis, excisional, laparoscopy, laparotomy

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Condition tags

endometriosisendometriomadysmenorrheainfertility

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