“The quality of the surgery, not necessarily the procedure per se, holds the key to conclusively treating endometriosis.” Read more in the October 2015 feature on endometriosis in Contemporary OB/GYN:
Endometriosis is a challenging entity affecting an estimated 176 million women worldwide.1Associated symptoms include significant pain, infertility, dysuria, dysmenorrhea, dyspareunia, dyschezia, and other physical and quality-of-life issues. Comprehensive clinical evaluation is strongly recommended for early and accurate detection in order to afford timely management.
Although signs of endometriosis can occur during adolescence, diagnosis is often delayed for years, with knowledge deficits contributing to consequential diagnostic delays, suboptimal treatments, and poor outcomes. Treatment mainstays include analgesic, surgical, and medical approaches, alone or in combination. Several guidelines have been developed by various consortia, but controversy and uncertainty over best practice for treatment remain.2
Unfortunately, therapy is often ineffective and incomplete, with high rates of recurrence when the disease is left intact. Hence, it is my opinion that laparoscopic excision (LAPEX) is and should remain the standard of care. The quality of the surgery, not necessarily the procedure per se, holds the key to conclusively treating endometriosis.
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