Evaluation of the role of laser treatment for the treatment of pain in endometriosis.
There have been few appropriately conducted trials to evaluate the effectiveness of laser destruction of endometriosis in relieving pain symptoms, yet the techniques are increasingly being used. Laser destruction has been shown to be more effective than the placebo effect of laparoscopy alone in one trial, at least at 6-month follow-up. Longer-term studies suggest increasing recurrence of symptoms with time [23% at 12 months in one study, and 44% by a mean of 19.7 months (5-60) follow-up]. These recurrence rates are similar to those seen following 6 months medical treatment. It is unknown whether laparoscopic uterosacral nerve ablation (LUNA) in addition to destruction of lesions will produce better results, and appropriate trials are needed in several areas to determine the role of laser therapy.
Shaw
R W
RW
Academic Division of Obstetrics & Gynaecology, School of Human Development, University of Nottingham, Clinical Sciences Building, Derby City General Hospital, Uttoxeter Road, Derby, UK. robert.shaw@nottingham.ac.uk
D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D053685:Laser Therapy / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome