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Endometriosis - Management
What surgical treatments are available for confirmed endometriosis?
- Surgical treatment aims to remove (excise) or destroy (ablate) areas of endometriosis in order to improve symptoms, and increase the chance of pregnancy.
- Ideally, endometriosis should be removed or destroyed at the time of diagnosis.
- However this may not be possible as symptoms do not always relate to severity: unexpectedly severe disease may be discovered at laparoscopy.
- Surgery for severe endometriosis should only be performed in a specialized tertiary endometriosis centre.
- Surgical treatment may be conservative (minimally invasive when continued fertility is required) or radical (when continuing fertility is no longer required).
- Conservative surgery is generally carried out laparoscopically and includes techniques such as diathermy, laser ablation or excision of deposits, ovarian cystectomy, denervation procedures, and helium plasma coagulation.
- Radical surgery (such as total abdominal hysterectomy or salpingo-oophorectomy) is reserved for women who have completed their families and in whom other treatments have failed.
- Relapse is common after surgical procedures for endometriosis; it may be as high as 50% at 1-year follow up.
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