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Laparoscopic Surgery for Endometriosis

How Well It Works

Pain relief

As with hormone therapy, surgery relieves endometriosis pain for most women. But it does not guarantee long-lasting results. Some studies have shown:

Most women—about 60% to 95%—report pain relief in the first months after surgery.^{Reference 1}
About 45% of women have symptoms return within the first year after surgery. This number increases over time.^{Reference 2}

Some studies suggest that using hormone therapy after surgery can make the pain-free period longer by preventing the growth of new or returning endometriosis.^{Reference 1}

Infertility

If infertility is your primary concern, your doctor will probably use laparoscopy to look for and remove signs of endometriosis.

Research has not firmly proved that removing mild endometriosis improves fertility.^{Reference 3}
For moderate to severe endometriosis, surgery will improve your chances of pregnancy.^{Reference 4}
In some severe cases, a fertility specialist will recommend skipping surgical removal and using Reference in vitro fertilization Opens New Window.

After laparoscopy, your next steps depend on how severe your endometriosis is and your age. If you are older than 35, Reference egg quality declines and miscarriage risk increases with each passing year. In that case, your doctor may recommend infertility treatment, such as Reference fertility drugs Opens New Window, Reference insemination Opens New Window, or in vitro fertilization. If you are younger, consider trying to conceive without infertility treatment.

Endometrioma

There are various ways of surgically treating an endometrioma, including draining it, cutting out part of it, or removing it completely (cystectomy). Any of these treatments brings pain relief for most women but not all. Cystectomy is most likely to relieve pain for a longer time, prevent an endometrioma from growing back, and prevent the need for another surgery.^{Reference 3}

By:	Reference Healthwise Staff	Last Revised: July 7, 2011
Medical Review:	Reference Adam Husney, MD, MD - Family Medicine Reference Kirtly Jones, MD, MD - Obstetrics and Gynecology