Surgical Treatment of Endometriosis Current Trends and Controversies

Endometriosis is a hormone –dependent progressive inflammatory disorder that develops whenendometrial- like tissue is formed outside of the uterine cavity. Chronic pain, infertility, and organdysfunction are the clinical features.Treatment of endometriosis must be individualized, taking intoconsideration the clinical problem.Depending on the severity of disease, diagnosis and removal the endometriosis should beperformed simultaneously at the time of surgery. The goal of surgery is to excise is to visible lesionsand peritoneal lesions, adhesions, ovarian cysts, deep rectovaginal endometriosis and to restorenormal anatomy. Laparoscopy is preferred over laparotomy.One of the optimal management forendometriosis –associated pain requires possible egg preservation in affected young patients withor without endometriomas.Treatment of Endometriosis –Associated PainConservative SurgeryPeritoneal EndometriosisThe best surgical approach for the treatment of superficial endometriosis is controversial. Recentstudies demonstrated that excision of endometriosis was superior to coagulation in reducingpain,but no evidence is available to show the superiority of one technique over another.