Laparoscopic uterine suspension as an adjunctive procedure at the time of laser laparoscopy for the treatment of endometriosis.
Uterine suspension has been advocated as an adjunctive procedure at the time of conservative surgery for endometriosis but has seldom been used at the time of CO2 laser laparoscopic treatment of endometriosis. In this study of 225 patients treated for cul-de-sac endometriosis by CO2 laser laparoscopy between 1984 and 1989 uterine suspension was performed as an adjunctive procedure at the time of laparoscopy. The result was a cumulative pregnancy rate of 80.0%. Life-table analysis was performed, and monthly fecundity rates were calculated as 15.58%, 6.29%, 17.86% and 7.89% for Revised American Fertility Society (RAFS) endometriosis stages I to IV respectively. CO2 laser laparoscopy and laparoscopic uterine suspension alleviated preoperative pelvic pain complaints in 94% of the patients. Monthly fecundity rates for RAFS stage I endometriosis, which exceeded previously reported rates following expectant management, medical management and conservative surgery, were attributed to laparoscopic uterine suspension, which had not been previously reported as an adjunct to CO2 laser laparoscopy.
Ivey
J L
JL
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas.
D004715:Endometriosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D053685:Laser Therapy; D007902:Length of Stay; D015993:Life Tables; D010146:Pain / Q000209:etiology; D010388:Pelvis; D011247:Pregnancy; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014599:Uterus / Q000601:surgery*