Laparoscopic treatment of deep endometriosis located on the uterosacral ligaments.

The goal of this study was to assess the efficiency of laparoscopic surgical treatment of pain for patients presenting deep endometriosis located on the uterosacral ligaments. To this end we analysed a continuous series of 21 patients treated by laparoscopic surgery between January 1993 and June 1994. In all these cases treatment consisted of resection of all the uterosacral ligament(s) presenting deep endometriotic lesions together with exercise of all other endometriotic lesions. No complications were observed per- or postoperatively. The results were assessed for all the patients with a minimum follow-up of one year. The efficiency of the treatment varied according to the symptoms. Patients who presented dysmenorrhoea (19 cases) improved in 84.2% of cases (16 patients). Out of the 17 patients who presented deep dyspareunia, improvement was evident for 94.1% of cases (16 patients). The chronic pelvic pain suffered improved in seven out of nine cases (77.7%). Patients who benefited from an improvement rated it excellent or satisfactory in over 80% of cases. These results demonstrate that, provided the surgeon is highly skilled in laparoscopy, laparoscopic surgery is efficient for the treatment of patients presenting painful symptoms related to deep endometriotic implants located on the uterosacral ligaments.