Reproductive outcome after treatment of mild endometriosis with laparoscopic excision and electrocoagulation.
OBJECTIVE
To compare the pregnancy rates (PRs) of infertile women with mild endometriosis treated laparoscopically by surgical excision and by electrocoagulation. Laparoscopic treatment of minimal and mild endometriosis usually is done by laser or electrocoagulation. Whether surgical excision is associated with similar results is unknown.


METHODS
Retrospective study with a historical control.


METHODS
University teaching hospitals.


METHODS
One hundred one infertile women undergoing laparoscopic treatment of mild endometriosis.


METHODS
Forty-eight women were treated with electrosurgery (historical control) and 53 women were treated with excision.


METHODS
The PRs of the two groups of women were evaluated using life-table calculations and the Mantel-Cox test.


RESULTS
Of the total 24 pregnancies (PR: 57.1%) in the electrosurgery group, there were 3 spontaneous abortions (12.5%) and 1 ectopic pregnancy (4.2%). The total PR in the excision group was 53.5%, the abortion rate was 17.4% (4 of 23), and the ectopic PR was 8.7% (2 of 23). The median interval between surgery and conception was 10.7 months in the electrosurgery group and 13.3 months in the excision group. There was no statistically significant difference in the probability of conception between the two groups of women (Mantel-Cox test: z = 0.24). Using the Cox proportional-hazards model, the effects of age and duration of infertility were evaluated and were found not to be associated with a decreased PR.


CONCLUSIONS
There is no difference in the PRs of infertile women with mild endometriosis treated laparoscopically by surgical excision and by electrocoagulation. The difference between these two modalities in women with endometriosis-related pelvic pain remains to be determined.
Tulandi
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Department of Obstetrics and Gynecology, McGill University, Royal Victoria Hospital, Montreal, Quebec, Canada. togas@rvhob2.lan.mcgill.ca
al-Took
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D000328:Adult; D004564:Electrocoagulation; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D015993:Life Tables; D011247:Pregnancy; D018873:Pregnancy Rate; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome