Pain relief after combined medical and laparoscopic conservative treatment of stage III–IV endometriosis: A comparison with medical therapy

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Abstract
In this prospective clinical trial, we evaluate the efficacy of combined medical and laparoscopic conservative treatment of extensive endometriosis associated with chronic pelvic pain. Thirty-two patients with stage III–IV endometriosis allocated to combined medical and laparoscopic surgical treatment were compared with a control group of 20 patients with the same characteristics who were given medical treatment alone. The second-look laparoscopy in the combined treatment group showed good anatomic outcome. Results in terms of pain relief were also very good in the patients who underwent combined treatment, with a highly significant difference (P lt; 0.001) in comparison with the medical treatment control group. Unfortunately, no conservative treatment of endometriosis protects the patient from the risk of recurrence. Nevertheless, we believe that the combination of laparoscopic conservative surgery with medical treatment is useful in achieving optimal anatomic results and is very effective in relieving pain.