Laparoscopic Surgery in the Treatment of Endometriosis

Abstract

Endometriotic cyst, or endometrioma, represents about 25% of all ovarian cystic tumors and can be responsible for dismenorhea, dispareunia and infertility. Medicamentous therapy of endometrioma is not efficient, but can be useful as an adjuvant therapy after surgery. Both transvaginal and laparoscopic puncture and drainage of endometrioma have high recurrence rates. Laparoscopy is the treatment of choice, regardless whether laparoscopic fenestration of cyst and ablation or stripping technique is performed. Fenestration and ablation is a conservative technique regarding the sparing of ovarian tissue, but has higher recurrence rates. Stripping technique has been confirmed as a method with lower recurrence and higher pregnancy rates. The controversial data regarding the loss of ovarian tissue by stripping technique should be further evaluated.