What is the role of surgery in the treatment of endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Answer

Surgical care can be broadly classified as conservative when reproductive potential is retained, semiconservative when reproductive ability is eliminated but ovarian function is retained, and radical when the uterus and ovaries are removed. Age, desire for future childbearing, and deterioration of quality of life are the main considerations when deciding on the extent of surgery.

Surgical efforts are aimed at removal of the endometrial implants and correction of anatomic distortions. Implants can be ablated using either laser energy or electrosurgical techniques.

Resection of the implants and adjacent peritoneum is considered the treatment of choice by some authors. A radical surgical approach involves total hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO). This is generally reserved for women who have completed their family or for women with severely disabling pain that is unresponsive to more conservative approaches.


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