title: Laparoscopy and reported pain among patients with endometriosis.
abstract: OBJECTIVE
  To compare the effectiveness of sharp excision of endometriosis with sham surgical excision in alleviating endometriosis-associated pain for up to 1 year following surgery.
  
  
  METHODS
  Patients requiring a laparoscopy for severe pelvic pain were eligible. If endometriosis was visually identified at laparoscopy, a biopsy of a representative lesion was taken. The women were then randomized either to have all remaining endometriosis excised with laparoscopic scissors (the excision group) or to have no further surgical treatment (the control group). Patients were asked to complete daily pain scales for 1 month preoperatively and quarterly for 1 year postoperatively. Subjects were blinded to their treatment allocation for 1 year.
  
  
  RESULTS
  Twenty-nine women underwent laparoscopy and biopsy and were randomized to have excision or no treatment of endometriosis. The excision and control groups were similar in age, parity, and revised American Society for Reproductive Medicine stage of disease. Sixteen women completed the full year of follow-up: 9 in the excision group, and 7 in the control group. Overall, recorded pain was significantly reduced at 1 year (P < 0.05), with no significant difference between the excision and control groups.
  
  
  CONCLUSIONS
  Laparoscopy with diagnostic biopsy alone is associated with a significant reduction in pain for up to 1 year postoperatively. Although the study lacked sufficient statistical power to exclude an effect of excision, pain relief in each group was similar. These results indicate a potential benefit of sham surgical procedures in assessing novel surgical interventions.
authors.affiliation: Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Jarrell
authors.forename: Ruchi
authors.initials: R
authors.lastname: Mohindra
authors.forename: Sue
authors.initials: S
authors.lastname: Ross
authors.forename: Paul
authors.initials: P
authors.lastname: Taenzer
authors.forename: Rollin
authors.initials: R
authors.lastname: Brant
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010147:Pain Measurement; D010919:Placebos; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D010919:Placebos