Cited by 134Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

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Surgical management of endometriosis

Donnez, Jacques, Pirard, Céline, Smets, Mireille, Jadoul, Pascale, Squifflet, Jean·2004·Best Practice & Research Clinical Obstetrics & Gynaecology

DOI 10.1016/j.bpobgyn.2004.03.004

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Abstract

The efficacy of medical and surgical treatment of endometriosis-associated infertility and pelvic pain is a source of ongoing controversy. Complete resolution of endometriosis is not yet possible and current therapy has three main objectives: (1) to reduce pain; (2) to increase the possibility of pregnancy; and (3) to delay recurrence for as long as possible. It is possible that a consensus will never be reached on the optimal treatment of minimal and mild endometriosis. In case of moderate and severe endometriosis-associated infertility, the combined approach (operative laparoscopy with a gonadotropin-releasing hormone (GnRH) agonist) should be considered as 'first-line' treatment. The mean pregnancy rate of 50% reported in the literature following surgery provides scientific proof that operative treatment should first be undertaken to give our patients the best chance of conceiving naturally. In case of rectovaginal adenomyotic nodules, surgery must be considered as first-line therapy, medical therapy being relatively in-efficacious.

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Authors: Donnez, J., Pirard, C., Smets, M., Jadoul, P., & Squifflet, J.
Affiliations: Cliniques Universitaires Saint-Luc (BE)
Corresponding author: Donnez, Jacques
ORCID: Donnez, Jacques
Pirard, Céline
Squifflet, Jean
Venue: Best Practice & Research Clinical Obstetrics & Gynaecology
Publisher: Elsevier BV
Published: 2004-04
Volume: 18
Issue: 2
Pages: 329-348
ISSN: 1521-6934 (ISSN-L)
DOI: 10.1016/j.bpobgyn.2004.03.004
OpenAlex: W2106304510
Cited by: 134
References: 114
Citations by year: 2026: 3 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 9 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 3 · 2016: 4 · 2015: 11 · 2014: 3 · 2013: 7 · 2012: 9
FWCI: 1.15
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Best Practice & Research Clinical Obstetrics & Gynaecology (publishedVersion)
PubMed (publishedVersion)
Digital Access to Libraries (submittedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Health Sciences › Medicine › Obstetrics and Gynecology › Ectopic Pregnancy Diagnosis and Management
Keywords: endometriosis, surgical management, endometriosis-associated infertility, pelvic pain, laparoscopic surgery, GnRH agonist, pregnancy rate, recurrence
MeSH terms: Endometriosis, Female, Humans, Infertility, Female, Ovarian Diseases, Peritoneal Diseases, Laparoscopy, Retroperitoneal Space, Evidence-Based Medicine

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