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Cited by 80Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

Endometriosis: Current management

Lu, Peter Y., Ory, Steven J.·1995·Mayo Clinic Proceedings
DOI 10.4065/70.5.453
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Abstract

Objective To review the clinical features, theories of pathogenesis, and current treatment of endometriosis-associated pain and infertility.Design We review the manifestation of endometriosis and the possible mechanisms that lead to its symptoms, examine the efficacy of current therapeutic options for pelvic pain and infertility, and provide specific recommendations for treatment based on the current literature.Material and methods Endometriosis is the presence of hormonally responsive endometrial tissue occurring outside the uterine cavity. This condition may be asymptomatic but is often found in association with pelvic pain or infertility (or both). The precise pathogenesis has not been clearly established but likely involves retrograde menstruation with subsequent seeding of endometrial glands at extrauterine sites. The definitive diagnosis and staging of endometriosis are performed by laparoscopy. Various strategies have been used to treat endometriosis including expectant, medical, surgical, and combination management.Results The efficacy of treatment varies for pelvic pain and infertility. Endometriosis-associated pain may respond to both medical and surgical management. The use of medical therapy for endometriosis-associated infertility is not supported by current studies. Surgical management of infertility may be efficacious when pelvic anatomy is distorted because of endometriosis. The use of superovulation strategies and in vitro fertilization has been shown to be effective in overcoming endometriosis-associated infertility.Conclusion Pelvic pain and infertility in the presence of endometriosis necessitate individualization of therapy to achieve treatment goals. Neither medical nor surgical management is efficacious in all circumstances. As a better understanding of the pathogenesis of endometriosis evolves, treatment of this perplexing condition will probably continue to improve.

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  • Endometriosis is found in 0.1-53% of women operated on laparoscopically or by laparotomy, of which 12-32% are women after diagnostic laparoscopy due to pelvic pain delays and 10-60% after diagnostic laparoscopy due to disability.

    “Literature data indicate that endometriosis is found in 0.1–53% of women operated on laparoscopically or by laparotomy, of which 12–32% are women after diagnostic laparoscopy due to pelvic pain delays and 10–60% of the patient after diagnostic laparoscopy due to disability [19,20,21].”

    From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [19]

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Authors
Lu, P. Y., & Ory, S. J.
Affiliations
Mayo Clinic (US)
Corresponding author
Lu, Peter Y.
ORCID
Venue
Mayo Clinic Proceedings
Publisher
Elsevier BV
Published
1995-05
Volume
70
Issue
5
Pages
453-463
ISSN
0025-6196 (ISSN-L)
DOI
10.4065/70.5.453
OpenAlex
W1977583704
Cited by
80
References
65
Citations by year
2026: 1 · 2025: 1 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 2 · 2014: 3 · 2013: 1 · 2012: 2
FWCI
1.44
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Mayo Clinic Proceedings (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 › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Keywords
endometriosis, pelvic pain, infertility, endometriosis pathogenesis, retrograde menstruation, diagnostic laparoscopy, surgical management, medical therapy, superovulation, in vitro fertilization, expectant management
MeSH terms
Tissue Adhesions, Adult, Endometriosis, Female, Fertilization in Vitro, Hormones, Humans, Hysterectomy, Infertility, Female, Laparoscopy, Superovulation, Surgical Procedures, Operative, Pelvic Pain, CA-125 Antigen

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