Surgical treatment of different types of endometriosis: Comparison of major society guidelines and preferred clinical algorithms

Best Pract Res Clin Obstet Gynaecol. 2018 Aug:51:102-110. doi: 10.1016/j.bpobgyn.2018.01.020. Epub 2018 Feb 16.

Abstract

Treatment options for patients with different types of endometriosis - superficial, ovarian, or deep - vary depending on the clinical presentation. New findings in the recent years regarding the role of preoperative imaging, efficacy of medical therapy, and effect of surgery on ovarian reserve have changed the way we understand the disease and subsequently the way we treat our patients. Practicing clinicians frequently refer to published recommendations from major societies for treatment guidelines. This paper aims to present and compare the varying major society guidelines on the indications and best surgical treatment approach for the management of the different types of endometriosis. We also present our preferred surgical treatment algorithm given the evidence in the literature and our cumulative 30-year clinical experience in a large tertiary referral center.

Keywords: Deep endometriosis; Endometriosis; Ovarian endometrioma; Superficial endometriosis; Surgical treatment.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Chronic Pain / etiology
  • Chronic Pain / surgery
  • Clinical Decision-Making
  • Endometriosis / classification
  • Endometriosis / complications
  • Endometriosis / pathology
  • Endometriosis / surgery*
  • Female
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / surgery
  • Laparoscopy
  • Practice Guidelines as Topic*
  • Reproductive Techniques, Assisted
  • Severity of Illness Index