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Recommendations for the Surgical Treatment of Endometriosis.

Part 1: Ovarian Endometrioma

This paper was produced by the European Society for Gynaecological Endoscopy (ESGE), ESHRE, and the World Endometriosis Society (WES) looking at the different types of surgery for endometriosis. Endometriosis is frequently found in peritoneal lesions, deep endometriosis and ovarian endometriotic cysts (endometriomas). Medical therapies may be used to treat endometriosis, but surgery is also often used to treat endometriomas. There are risks associated with surgery as it can damage the follicles in the ovaries and reduce fertility.


This paper describes the main types of surgery which are used to treat endometriomas in women who may want to have children in the future. Surgery types include:

· Cystectomy: Cyst is cut out

· Ablation: Cyst lining is removed by using a laser beam or plasma energy

· Electrosurgery: An electric current is used.


Particularly for larger endometriomas, combined technique or 2- to 3-step approach can also be considered.


This paper discusses technical details on the management of endometriosis using different types of surgery. This paper also provides general recommendations on pre-operative planning and patient counselling and emphasizes on the careful consideration of potential risks associated to surgery to ensure the best outcomes. The recommendations should be read in conjunction with the previous published guidelines on clinical management of endometriosis.


Reference:


Working group of ESGE, ESHRE and WES, Saridogan, E., Becker, C. M., Feki, A., Grimbizis, G. F., Hummelshoj, L., Keckstein, J., Nisolle, M., Tanos, V., Ulrich, U. A., Vermeulen, N., & De Wilde, R. L. (2017). Recommendations for the Surgical Treatment of Endometriosis. Part 1: Ovarian Endometrioma. Human reproduction open, 2017(4), hox016. https://doi.org/10.1093/hropen/hox016


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