Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal, mild, and moderate endometriosis.
OBJECTIVE
To assess the efficacy of laser laparoscopic surgery in the treatment of pain associated with minimal, mild, and moderate endometriosis.


METHODS
A prospective, randomized, double-blind, and controlled clinical study.


METHODS
Royal Surrey County Hospital, Guildford, United Kingdom, a referral center for the laser laparoscopic treatment of endometriosis.


METHODS
Sixty-three patients with pain (dysmenorrhoea, pelvic pain, or dyspareunia) and minimal to moderate endometriosis.


METHODS
The patients were randomized at the time of laparoscopy to laser ablation of endometriotic deposits and laparoscopic uterine nerve ablation or expectant management. Pain symptoms were recorded subjectively and by visual analogue scale. The women were unaware of the treatment allocated as was the nurse who assessed them at 3 and 6 months after surgery.


METHODS
Improvement or resolution of pain symptoms assessed subjectively and by visual analogue score.


RESULTS
Laser laparoscopy results in statistically significant pain relief compared with expectant management at 6 months after surgery. Sixty-two and a half percent of the lasered patients reported improvement or resolution of symptoms compared with 22.6% in the expectant group. Results were poorest for minimal disease and, if patients with mild and moderate disease only are included, 73.7% of patients achieved pain relief. There were no operative or laser complications.


CONCLUSIONS
Laser laparoscopy is a safe, simple, and effective treatment in alleviating pain symptoms in women with stages I, II, and III endometriosis.
Sutton
C J
CJ
Department of Obstetrics and Gynaecology, Royal Surrey County Hospital, Guildford, United Kingdom.
Ewen
S P
SP
Whitelaw
N
N
Haines
P
P
D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D004715:Endometriosis / Q000150:complications* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D053685:Laser Therapy; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology*; D011446:Prospective Studies; D012086:Reoperation