Surgical Treatment of Endometriosis: Excision Versus Ablation of Peritoneal Disease

Abstract

The issue of the role of excision versus ablation of endometriosis on the peritoneum is the subject of intense public and professional disagreement. If we compare this debate with treatment of an endometrioma, excision of a cyst is associated with a reduced rate of recurrence, reduced symptom recurrence, and increased spontaneous pregnancy rates (odds ratio = 5.1; 95% confidence interval, 2.04–13.29) compared with ablative surgery [ 1 Hart R.J. Hickey M. Maouris P. Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev. 2008; (CD004992) Google Scholar ]. There is no debate on the efficacy of excision of a cyst over ablation. The main reason is that recurrence is an easily observable event by imaging. The debate is on other factors such as the effect of excision on ovarian reserve and pregnancy outcome with assisted reproductive technology. However, with peritoneal disease, the debate is intense for many reasons, which we discuss here. Surgical Excision Versus Ablation for Superficial Endometriosis-Associated Pain: A Randomized Controlled TrialJournal of Minimally Invasive GynecologyVol. 26Issue 1PreviewTo compare surgical excision and ablation of endometriosis for treatment of chronic pelvic pain. Full-Text PDF