Endometriosis surgery: Difference between revisions

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==Overview==
==Overview==
Surgery is not the first-line treatment option for patients with endometriosis. Surgery is usually reserved for patients with either patients with failed medical therapy and patients with stage 3 or stage 4 disease.
Surgery is not the first-line treatment option for patients with endometriosis. Surgery is usually reserved for patients with failed medical therapy and patients with stage 3 or stage 4 disease.


==Surgery==
==Surgery==
Surgical therapy for endometriosis can be conservative or definitive based on the patient's presentation.<ref name="pmid28189295">{{cite journal| author=Singh SS, Suen MW| title=Surgery for endometriosis: beyond medical therapies. | journal=Fertil Steril | year= 2017 | volume= 107 | issue= 3 | pages= 549-554 | pmid=28189295 | doi=10.1016/j.fertnstert.2017.01.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28189295  }} </ref>
Surgical therapy for endometriosis can be classified as conservative or definitive based on the presentation of the patient.<ref name="pmid28189295">{{cite journal| author=Singh SS, Suen MW| title=Surgery for endometriosis: beyond medical therapies. | journal=Fertil Steril | year= 2017 | volume= 107 | issue= 3 | pages= 549-554 | pmid=28189295 | doi=10.1016/j.fertnstert.2017.01.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28189295  }} </ref>
*'''Conservative therapy:'''  
*'''Conservative therapy:'''  
**It is preferred in young women who desire to get [[pregnant]] and in patients with no improvement of pain with medical therapy.
**Conservative therapy is preferred in young women who desire to get [[pregnant]] and in patients with no improvement of pain after pharmacological treatment.
**Sugery includes removal of the endometrial lesions with excision of destruction of the lesion by [[laser]] or [[electrocautery]].
**Surgery includes removal of the endometrial [[lesions]] with excision and destruction of the [[Lesions|lesion]] by [[laser]] or [[electrocautery]].
**Laparoscopic uterosacral nerve ablation or laparoscopic presacral neurectomy can be done for chronic pelvic pain.<ref name="pmid26441217">{{cite journal| author=Api M| title=Surgery for endometriosis-related pain. | journal=Womens Health (Lond) | year= 2015 | volume= 11 | issue= 5 | pages= 665-9 | pmid=26441217 | doi=10.2217/whe.15.52 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26441217  }} </ref>
**[[Laparoscopic surgery|Laparoscopic]] uterosacral nerve [[ablation]] or laparoscopic pre sacral [[neurectomy]] can be done for [[chronic pelvic pain]].<ref name="pmid26441217">{{cite journal| author=Api M| title=Surgery for endometriosis-related pain. | journal=Womens Health (Lond) | year= 2015 | volume= 11 | issue= 5 | pages= 665-9 | pmid=26441217 | doi=10.2217/whe.15.52 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26441217  }} </ref>
*'''Definitive surgery:'''  
*'''Definitive surgery:'''  
**It is preferred in patients after child bearing age and elderly women or women with ureteral or [[bowel obstruction]].<ref name="pmid28186620">{{cite journal| author=Cranney R, Condous G, Reid S| title=An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma. | journal=Acta Obstet Gynecol Scand | year= 2017 | volume= 96 | issue= 6 | pages= 633-643 | pmid=28186620 | doi=10.1111/aogs.13114 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28186620  }} </ref>
**Definitive surgery is preferred in patients past their child-bearing years and in elderly women or women with ureteral or [[bowel obstruction]].<ref name="pmid28186620">{{cite journal| author=Cranney R, Condous G, Reid S| title=An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma. | journal=Acta Obstet Gynecol Scand | year= 2017 | volume= 96 | issue= 6 | pages= 633-643 | pmid=28186620 | doi=10.1111/aogs.13114 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28186620  }} </ref>
**Definitive surgery preferred is a total [[hysterectomy]] with [[Salpingo-oophorectomy|bilateral salpingo-oophorectomy]].
**The preferred definitive surgery is a total [[hysterectomy]] with [[Salpingo-oophorectomy|bilateral salpingo-oophorectomy]].


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 12:21, 17 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]

Overview

Surgery is not the first-line treatment option for patients with endometriosis. Surgery is usually reserved for patients with failed medical therapy and patients with stage 3 or stage 4 disease.

Surgery

Surgical therapy for endometriosis can be classified as conservative or definitive based on the presentation of the patient.[1]

References

  1. Singh SS, Suen MW (2017). "Surgery for endometriosis: beyond medical therapies". Fertil Steril. 107 (3): 549–554. doi:10.1016/j.fertnstert.2017.01.001. PMID 28189295.
  2. Api M (2015). "Surgery for endometriosis-related pain". Womens Health (Lond). 11 (5): 665–9. doi:10.2217/whe.15.52. PMID 26441217.
  3. Cranney R, Condous G, Reid S (2017). "An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma". Acta Obstet Gynecol Scand. 96 (6): 633–643. doi:10.1111/aogs.13114. PMID 28186620.