Marina de Paula Andres1, Giuliano M Borrelli1, Rosanne M Kho2, Mauricio S Abrão3. 1. Division of Endometriosis, Department of Obstetrics and Gynecology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. 2. Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA. 3. Division of Endometriosis, Department of Obstetrics and Gynecology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil - msabrao@mac.com.
Abstract
INTRODUCTION: Endometriosis is a chronic inflammatory disease that affects young women in reproductive age. It has mainly three different clinical presentations: superficial (peritoneal), ovarian (endometriomas) and deep endometriosis (DE). The last one is the most advanced form of the disease, frequently impairing fertility and harming women's quality of life (QoL). EVIDENCE ACQUISITION: We conducted a systematic review on the surgical treatment of DE in the last ten years focusing on its benefits to improve QoL and for pain relief as well as related surgical complications. EVIDENCE SYNTHESIS: Twenty-three studies were included for qualitative analysis. Overall, included studies showed a relevant improvement in QoL as well as in pain scores using specific questionnaires and the ten-point Visual Analogue Scale (VAS) for pain. CONCLUSIONS: Until further comparative studies regarding medical versus surgical treatment for DE are concluded, currently, surgery is the best option for patients with DE and severe pain (VAS>7).
INTRODUCTION: Endometriosis is a chronic inflammatory disease that affects young women in reproductive age. It has mainly three different clinical presentations: superficial (peritoneal), ovarian (endometriomas) and deep endometriosis (DE). The last one is the most advanced form of the disease, frequently impairing fertility and harming women's quality of life (QoL). EVIDENCE ACQUISITION: We conducted a systematic review on the surgical treatment of DE in the last ten years focusing on its benefits to improve QoL and for pain relief as well as related surgical complications. EVIDENCE SYNTHESIS: Twenty-three studies were included for qualitative analysis. Overall, included studies showed a relevant improvement in QoL as well as in pain scores using specific questionnaires and the ten-point Visual Analogue Scale (VAS) for pain. CONCLUSIONS: Until further comparative studies regarding medical versus surgical treatment for DE are concluded, currently, surgery is the best option for patients with DE and severe pain (VAS>7).