Endometriosis surgery: Difference between revisions
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==Overview== | ==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== | ==Surgery== | ||
Surgical therapy for endometriosis can be conservative or definitive based on the patient | Surgical therapy for endometriosis can be classified as conservative or definitive based on the presentation of the patient.<ref name="pmid28189295">{{cite journal| author=Singh SS, Suen MW| title=Surgery for endometriosis: beyond medical therapies. | journal=Fertil Steril | year= 2017 | volume= 107 | issue= 3 | pages= 549-554 | pmid=28189295 | doi=10.1016/j.fertnstert.2017.01.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28189295 }} </ref> | ||
*'''Conservative therapy:''' | *'''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 [[Lesions|lesion]] by [[laser]] or [[electrocautery]]. | ||
**Laparoscopic uterosacral nerve ablation or laparoscopic | **[[Laparoscopic surgery|Laparoscopic]] uterosacral nerve [[ablation]] or laparoscopic pre sacral [[neurectomy]] can be done for [[chronic pelvic pain]].<ref name="pmid26441217">{{cite journal| author=Api M| title=Surgery for endometriosis-related pain. | journal=Womens Health (Lond) | year= 2015 | volume= 11 | issue= 5 | pages= 665-9 | pmid=26441217 | doi=10.2217/whe.15.52 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26441217 }} </ref> | ||
*'''Definitive surgery:''' | *'''Definitive surgery:''' | ||
** | **Definitive surgery is preferred in patients past their child-bearing years and in elderly women or women with ureteral or [[bowel obstruction]].<ref name="pmid28186620">{{cite journal| author=Cranney R, Condous G, Reid S| title=An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma. | journal=Acta Obstet Gynecol Scand | year= 2017 | volume= 96 | issue= 6 | pages= 633-643 | pmid=28186620 | doi=10.1111/aogs.13114 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28186620 }} </ref> | ||
** | **The preferred definitive surgery is a total [[hysterectomy]] with [[Salpingo-oophorectomy|bilateral salpingo-oophorectomy]]. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 12:21, 17 August 2017
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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.