Endometriosis surgery: Difference between revisions
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**Laparoscopic uterosacral nerve ablation or laparoscopic presacral neurectomy can be done for chronic pelvic pain. | **Laparoscopic uterosacral nerve ablation or laparoscopic presacral neurectomy can be done for chronic pelvic pain. | ||
*'''Definitive surgery:''' | *'''Definitive surgery:''' | ||
**It is preferred in patients after child bearing age and elderly women or women with ureteral or bowel obstruction. | **It is preferred in patients after child bearing age and 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> | ||
**Definitive surgery is preferred with a total hysterectomy with bilateral salpingo-oophorectomy. | **Definitive surgery is preferred with a total hysterectomy with bilateral salpingo-oophorectomy. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 14:20, 16 June 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
Patients with failed medical therapy and patients with stage 3 or stage 4 disease are candidates for surgical therapy. Lazer and excision of the lesions is done for isolated lesions, total hysterectomy is reserved for patients with extensive disease.
Surgery
Surgical therapy for endometriosis can be conservative or definitive based on the patient's presentation.[1]
- Conservative therapy:
- It is preferred in young women who desire to get pregnant and in patients with no improvement of pain with medical therapy.
- Sugery includes removal of the endometrial lesions with excision of destruction of the lesion by laser or electrocautery.
- Laparoscopic uterosacral nerve ablation or laparoscopic presacral neurectomy can be done for chronic pelvic pain.
- Definitive surgery:
- It is preferred in patients after child bearing age and elderly women or women with ureteral or bowel obstruction.[2]
- Definitive surgery is preferred with 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.
- ↑ 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.