In a nutshell
This paper reviewed the safety and efficacy of surgical laparoscopy on treating endometriosis.
Some background
Endometriosis occurs when tissue that normally lines the uterus (womb) grows elsewhere, such as in the ovaries. This leads to pain in women with endometriosis, and is also associated with fertility problems. Treatment for endometriosis includes medications (such as pain medication) and surgery to remove the abnormal tissue. Surgery can be performed through laparoscopy. This is where a small incision is made and a tube is inserted in to remove tissue. There are different techniques in laparoscopic surgery; ablation destroys the tissue while excision cuts the tissue out. Risks of laparoscopic surgery include damage to organs.
Methods & findings
The authors reviewed 10 studies that analyzed women with endometriosis. Women who underwent laparoscopic treatment with ablation or excision were compared against women who did not undergo treatment but only had diagnostic laparoscopy (procedure to diagnose endometriosis).
3 months after the procedure, laparoscopic ablation or excision was not associated with decreased pain levels compared to women who did not have treatment. At 6 months, women who had laparoscopic ablation or excision were 6.58 times more likely to have decreased pain levels compared to women who did not have treatment. At 12 months, women who had laparoscopic ablation or excision were 10 times more likely to have decreased pain levels than women who did not have treatment. There was no difference between the pain levels of women who underwent ablation or excision.
Women who had laparoscopic ablation or excision were 1.94 times more likely to have an increased birth or pregnancy rate compared to women who did not have treatment.
2 studies looked at adverse events (undesired effect of surgical treatment) and found that no adverse events occurred.
The bottom line
The authors concluded that laparoscopic surgery to treat endometriosis might reduce pain and increase birth and pregnancy rates.
The fine print
Further research into this area is needed for more conclusive results.
Published By :
Cochrane database of systematic reviews
Date :
Apr 03, 2014
