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Cited by 525Endometriosis Research and TreatmentGynecological conditions and treatmentsEndometrial and Cervical Cancer Treatments

Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal, mild, and moderate endometriosis

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Sutton, Christopher J.G., Ewen, Simon P., Whitelaw, Naomi, Haines, Patricia·1994·Fertility and Sterility
DOI 10.1016/s0015-0282(16)56990-8
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Abstract

Objective To assess the efficacy of laser laparoscopic surgery in the treatment of pain associated with minimal, mild, and moderate endometriosis. Design A prospective, randomized, double-blind, and controlled clinical study. Setting Royal Surrey County Hospital, Guildford, United Kingdom, a referral center for the laser laparoscopic treatment of endometriosis. Patients Sixty-three patients with pain (dysmenorrhoea, pelvic pain, or dyspareunia) and minimal to moderate endometriosis. Interventions The patients were randomized at the time of laparoscopy to laser ablation of endometriotic deposits and laparoscopic uterine nerve ablation or expectant management. Pain symptoms were recorded subjectively and by visual analogue scale. The women were unaware of the treatment allocated as was the nurse who assessed them at 3 and 6 months after surgery. Main outcome measure Improvement or resolution of pain symptoms assessed subjectively and by visual analogue score. Results Laser laparoscopy results in statistically significant pain relief compared with expectant management at 6 months after surgery. Sixty-two and a half percent of the lasered patients reported improvement or resolution of symptoms compared with 22.6% in the expectant group. Results were poorest for minimal disease and, if patients with mild and moderate disease only are included, 73.7% of patients achieved pain relief. There were no operative or laser complications. Conclusions Laser laparoscopy is a safe, simple, and effective treatment in alleviating pain symptoms in women with stages I, II, and III endometriosis.

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Crossref · 10.1016/s0015-0282(16)56990-8

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26 of 26 references verified0 citation errors · 0 not checkable

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  • Just three randomized trials of endometriosis surgery effectiveness have been published.

    “Only three published randomized clinical studies evaluate the effectiveness of surgery (Sutton et al., 1994(Sutton et al., , 1997;;Jones et al., 2001;Abbott et al., 2004;Jarrell et al., 2005; Table II).”

    From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Sutton et al., 1994

  • Those with minimal disease seem more prone to early pain return after surgery.

    “Fourth, patients with the least amount of disease, appear more likely to re-experience pain soon after surgery (Sutton et al., 1994).”

    From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Sutton et al., 1994

  • Pain symptoms return sooner in women with minimal or mild endometriosis than in those with moderate or severe disease.

    “Furthermore, pain symptoms return sooner in women with minimal or mild endometriosis than those with moderate or severe disease (Sutton et al., 1994).”

    From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Sutton et al., 1994

  • After surgery for symptomatic endometriosis, about 20% of patients do not obtain relief, and those who fail are more likely to have minimal or mild endometriosis.

    “Studies on the effectiveness of surgery for symptomatic endometriosis illustrate that 20% of patients do not have relief after surgery and those who fail are more likely to have minimal or mild endometriosis (Sutton et al., 1994;Abbott et al., 2004;Jarrell et al., 2005).”

    From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Sutton et al., 1994

  • Longitudinal placebo-controlled trials with second-look laparoscopy demonstrated that 71-83% of untreated lesions progress or remain stable over a 12-month period.

    “longitudinal placebo-controlled trials with second look laparoscopy have demonstrated that 71–83% of untreated lesions will progress or remain stable over a 12-month period [14].”

    From Update on biomarkers for the detection of endometriosis (2015) · cites this paper as [14]

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Authors
Sutton, C. J. G., Ewen, S. P., Whitelaw, N., & Haines, P.
Affiliations
Royal Surrey County Hospital (GB)
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
1994-10
Volume
62
Issue
4
Pages
696-700
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/s0015-0282(16)56990-8
OpenAlex
W1755489631
Cited by
525
References
26
Citations by year
2026: 5 · 2025: 12 · 2024: 8 · 2023: 12 · 2022: 12 · 2021: 17 · 2020: 14 · 2019: 11 · 2018: 18 · 2017: 10 · 2016: 6 · 2015: 24 · 2014: 26 · 2013: 21 · 2012: 22
FWCI
8.58
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
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 › Endometrial and Cervical Cancer Treatments
Keywords
endometriosis, pelvic pain, dysmenorrhea, dyspareunia, laser ablation, expectant management, analgesia, minimal endometriosis, mild endometriosis
MeSH terms
Adolescent, Adult, Double-Blind Method, Endometriosis, Female, Follow-Up Studies, Humans, Middle Aged, Pain Measurement, Laparoscopy, Prospective Studies, Reoperation, Pelvic Pain, Laser Therapy

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