Predictive factors and treatment of recurrence of endometriosis.

Endometriosis remains an enigmatic disease process. The key is early recognition of symptoms and treatment. Treatment may begin with hormonal suppression. If medical suppression fails or if fertility is desired, surgical intervention should be used. During primary surgical intervention, the goal is for optimal treatment to decrease disease burden. However, despite adequate treatment, reoperation is needed in a good proportion of woman. Factors contributing to recurrence are multifactorial and some can be predicted and some pain recurrence occurs despite obvious evidence. Recurrent surgery should also aim to decrease disease burden and conservative versus definitive treatment is based on patient's childbearing status. In addition, use of medical treatment can temper recurrence rates. There is still tremendous work that must still be completed in the field of pain recurrence and disease recurrence with endometriosis.