[Surgical treatment of endometriosis]

Ovarian endometriotic cysts with adhesions and rectovaginal endometriosis are absolute indications for laparoscopic surgery. Peritoneal minimal endometriosis is considered a relative indications for surgery by many experts. The discussion is ongoing and more randomized studies are necessary. Ureteral and intestinal endometriosis are indicated for surgery in cases of deep infiltration of the ureteral or intestinal wall. In some cases the GnRH analogue (gonadotropin releasing hormone) can be given as neoadjuvant chemotherapy; after it interval endometriotic debulking is possible. In the case of endometriosis we must apply the same strict rules as in oncology especially as regards negative or positive histological findings.