Treatment of mild endometriosis with Nd:YAG laser under laparoscopy:a report of 100 cases

Objective: To evaluate the clinical result of treatment of mild endometriosis(EM) with the Nd:YAG laser under laparoscopy. Methods: A hundred patients with pelvic R AFS I～II stage EM diagnosed by laparoscopy because of infertility or dysmenorrhea were treated at the same time by photocoagulating the endometriotic lesion with the Nd:YAG laser. They were followed up for 12～24 months. Pregnancy and abortion rate, abnormality of neonates, and dysmenorrhea improvement were observed. Laparoscopy was performed again in 10 nonpregnant patients 6 months after laser treatment. Results: Pregnancy rate was 48%(44/92) for infertile cases, 76%(19/25) for those with only EM, and 37%(25/67)for those with EM and other infertile factors. All the pregnancies were achieved in 12 months and 75% were pregnant in 6 moths after laser treatment. Spontaneous abortion rate was 16%. Therapeutic induced abortion was performed in 3 cases. Term birth was present with normal neonate in 38 cases. Dysmenorrhea disappeared in 89%,improved in 6%,and no changed in 6%. In all the 6 patients who were previously treated by oral danazol or medroxyprogesterone acetate for 6 months without symptematic improvement dysmenorrhea disappearence and 2 of them got pregnant. Repeated laparoscopy revealed that the previous endometriotic lesion disappeared without any adhesion. Conclusion:For the treatment of patients with mild EM, the Nd: YAG laser laparoscopy is favourable in alleviating dysmenorrhea and improving fecundity.