[Laparoscopic surgery of endometriomas reduces pain and subfertility]

The Cochrane collaboration has published two reviews on endometriosis in 2014. The review by Duffy et al analyses ten RCTs focussing on pain or subfertility, and laparoscopic surgery results in lower pain scores and increased clinical pregnancy rate compared to diagnostic laparoscopy. The other review by Brown & Farguhar describes 17 systematic reviews also reporting on pain and subfertility, and it highlights the finding of gestagen-releasing intrauterine system being more effective than expectant management regarding pain relief. Surgical treatment of endometriomas should be performed by excision rather than ablation.