Endometriosis surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
Surgery is not the first-line treatment option for patients with endometriosis. Surgery is usually reserved for patients with failed medical therapy and patients with stage 3 or stage 4 disease.
Surgery
Surgical therapy for endometriosis can be classified as conservative or definitive based on the presentation of the patient.[1]
- Conservative therapy:
- Conservative therapy is preferred in young women who desire to get pregnant and in patients with no improvement of pain after pharmacological treatment.
- Surgery includes removal of the endometrial lesions with excision and destruction of the lesion by laser or electrocautery.
- Laparoscopic uterosacral nerve ablation or laparoscopic pre sacral neurectomy can be done for chronic pelvic pain.[2]
- Definitive surgery:
- Definitive surgery is preferred in patients past their child-bearing years and in elderly women or women with ureteral or bowel obstruction.[3]
- The preferred definitive surgery is a total hysterectomy with bilateral salpingo-oophorectomy.
References
- ↑ Singh SS, Suen MW (2017). "Surgery for endometriosis: beyond medical therapies". Fertil Steril. 107 (3): 549–554. doi:10.1016/j.fertnstert.2017.01.001. PMID 28189295.
- ↑ Api M (2015). "Surgery for endometriosis-related pain". Womens Health (Lond). 11 (5): 665–9. doi:10.2217/whe.15.52. PMID 26441217.
- ↑ Cranney R, Condous G, Reid S (2017). "An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma". Acta Obstet Gynecol Scand. 96 (6): 633–643. doi:10.1111/aogs.13114. PMID 28186620.