Tratamiento de la endometriosis I y II: Revisión de la literatura

Abstract

Objective: this manuscript was aimed at reviewing the available literature concerning treatment, for endometriosis I and II in managing pain, infertility and as coadjuvant in assisted-reproduction techniques. Methodology: the literature available in Pub-Med/Medline databases was reviewed, emphasising management-guidelines published between 1992 and 2007. Results: endometriosis is usually defined as being the presence of endometrial functional tissue from the uterine cavity found growing on organs in other parts of the body. Its form of presentation changes from slight forms lacking adherence (I-II) to severe forms accompanied by retraction and fixation of peritoneal, ovary and tubaric surfaces (III-IV). Endometriosis predominantly appears in females during their reproductive age, average age for onset of symptoms being 20,1 +/-6,8; occurring in all ethnic groups. Its prevalence is estimated as being 10%; nevertheless, it is found in 40% to 60% of females consulting for pelvic pain and in 20% to 30% of those who consult for infertility. Conclusions: no difference was found between different medical treatments in terms of reducing pain, choice of treatment being determined by a patient's age, the desire for becoming fertile and the indirect effect of such. Nevertheless, more random controlled studies are required for comparing their use to placebo or without treatment. Surgery has also been demonstrated to induce improvement, but no studies were found comparing medical to surgical handling. Medical treatment of endometriosis-associated infertility was not seen to be effective; however, surgical treatment seemed to be beneficial for states I and II in eliminating disease foci.