Endometriosis surgery
|
Endometriosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Endometriosis surgery On the Web |
|
American Roentgen Ray Society Images of Endometriosis surgery |
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.
- 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.
- Definitive surgery is preferred with a total hysterectomy with bilateral salpingo-oophorectomy.