title: Surgical management of pain and infertility secondary to endometriosis.
abstract: The management of pain and infertility secondary to endometriosis remains a challenge. Surgical management of early-stage endometriosis-associated infertility has only a mild effect with a number needed to treat of at least 12 to achieve one pregnancy. Excision of endometriomas provides the best outcome for fertility and pain; however, there is a potential to reduce the ovarian reserve. Pain relief is seen in most patients undergoing surgical management but with a high recurrence rate over time. Long-term postoperative medical suppressive therapy with oral contraceptives may have some benefit in reducing recurrence of symptoms. Hysterectomy is effective in the long-term management of chronic pain associated with endometriosis.
authors: Department of Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors: Gouri B
authors: GB
authors: Diwadkar
authors: Tommaso
authors: T
authors: Falcone
mesh_terms: D003276:Contraceptives, Oral / Q000627:therapeutic use; D004715:Endometriosis / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007247:Infertility, Female / Q000209:etiology* / Q000601:surgery; D017699:Pelvic Pain / Q000209:etiology* / Q000601:surgery; D011182:Postoperative Care; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D003276:Contraceptives, Oral