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Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma

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Published on: January 22, 2022

Laparoscopic surgery for endometriosis.

Celine Bafort¹, Yusuf Beebeejaun², Carla Tomassetti¹

¹Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.

The Cochrane Database of Systematic Reviews

|October 23, 2020

Summary

Laparoscopic surgery for endometriosis shows uncertain effects on pain but likely increases viable intrauterine pregnancy rates. More research is needed on live birth and safety outcomes for endometriosis treatments.

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Area of Science:

Gynecology
Surgical Oncology
Reproductive Medicine

Background:

Endometriosis is a condition causing pain and infertility.
Surgical interventions aim to remove endometriosis and restore anatomy.

Purpose of the Study:

To assess the effectiveness and safety of laparoscopic surgery for endometriosis-associated pain and infertility.

Main Methods:

Systematic review of 14 randomized controlled trials (RCTs) involving 1563 women.
Compared laparoscopic surgery with diagnostic laparoscopy, other surgical interventions, or medical treatments.
Assessed outcomes including pain, live birth, quality of life, and adverse events using GRADE methods.

Main Results:

Uncertainty exists regarding laparoscopic surgery's effect on overall pain compared to diagnostic laparoscopy.
Moderate evidence suggests laparoscopic surgery increases viable intrauterine pregnancy rates.
No data were available on live birth rates across comparisons.
Insufficient evidence on adverse events precluded safety conclusions.

Conclusions:

Laparoscopic surgery's impact on endometriosis pain remains uncertain compared to diagnostic laparoscopy.
Evidence suggests a potential benefit in viable intrauterine pregnancy rates.
Further research is required, particularly on live birth, safety, and comparisons with non-surgical interventions.