[The current treatment of genital endometriosis]

Three therapeutic strategies are available in treating genital endometriosis (GE): medical treatment only, surgical treatment only and a combination of both, i.e. medical and surgical treatment. The author reviews the combined approach to different forms of GE, namely: cervical, ovarian, tubal, adenomyosis, retrocervical, vaginal and perineal. The common problems in decision making are: the age of the patient and her reproductive function, the localization, spread and stage of the lesion, the possible coexisting inflammatory process and its sequellae, the endometrial hyperplasia and the destructive changes of the uterus and ovaries. Hormonal drugs of choice are the anti-gonadotropin danazol and the GnRH analogues. Introduction of argon, CO2 and YAG lasers proved effective in treating certain forms of GE. Therapy results depend on the severity and spread of the process, on resection volume and completeness, on full scale hormonal therapy as well as on rehabilitation. Close follow-up, including ultrasound examination every 3 months, should be provided for immediate detection of possible side effects and complications.