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Semin Reprod Med 2011; 29(2): 124-129
DOI: 10.1055/s-0031-1272474
© Thieme Medical Publishers

Surgical Management of Pain and Infertility Secondary to Endometriosis

Gouri B. Diwadkar1 , Tommaso Falcone1
  • 1Department of Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio
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Publication History

Publication Date:
24 March 2011 (online)

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ABSTRACT

The management of pain and infertility secondary to endometriosis remains a challenge. Surgical management of early-stage endometriosis-associated infertility has only a mild effect with a number needed to treat of at least 12 to achieve one pregnancy. Excision of endometriomas provides the best outcome for fertility and pain; however, there is a potential to reduce the ovarian reserve. Pain relief is seen in most patients undergoing surgical management but with a high recurrence rate over time. Long-term postoperative medical suppressive therapy with oral contraceptives may have some benefit in reducing recurrence of symptoms. Hysterectomy is effective in the long-term management of chronic pain associated with endometriosis.

KEYWORDS

Endometriosis - surgery - laparoscopy

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Tommaso FalconeM.D. 

Department of Obstetrics and Gynecology, Desk A-81, Cleveland Clinic

9500 Euclid Avenue, Cleveland, OH 44195

Email: FALCONT@CCF.ORG