Laparoscopic surgery for endometriosis: a long-term follow-up.
OBJECTIVE
To investigate if complete resolution of endometriosis by laparoscopic surgery is beneficial to postoperative fecundity, dysmenorrhea and dyspareunia.


METHODS
An observational comparative study on the outcome of laparoscopic surgery.


METHODS
Laparoscopically-treated symptomatic women with endometriosis (total n = 236); complete (n = 185) and incomplete (n = 51) surgery groups.


METHODS
Postoperative fecundity and symptom reduction.


RESULTS
With whole populations, no surgical completeness-related difference was observed in cumulative pregnancy rates during the postoperative days 0-400 (cycle fecundity rate = 0.0319). Further accumulation of pregnant cases was followed in the complete surgery group (final cumulative pregnancy rate = 80%), but not in the counterpart group (p = 0.003). The similar result was obtained when only r-AFS classification stages III and IV were compared (p = 0.007). No r-AFS stage-related difference was observed in cumulative pregnancy rates when only patients of complete surgery were selected for comparison. The surgery reduced dysmenorrhea (84.7%) and dyspareunia (80.0%).


CONCLUSIONS
Laparoscopic conservative surgery for endometriosis, especially when it is complete, increases fecundity and reduces disease-related symptoms, such as dysmenorrhea and dyspareunia.
Tokushige
M
M
Department of Obstetrics and Gynecology, Kyoto National Hospital,  Fushimi, Japan.
Suginami
H
H
Taniguchi
F
F
Kitaoka
Y
Y
D000328:Adult; D004412:Dysmenorrhea / Q000628:therapy; D004414:Dyspareunia / Q000628:therapy; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005298:Fertility; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D016896:Treatment Outcome