PAIN RELIEF AFTER COMBINED MEDICAL AND LAPAROSCOPIC CONSERVATIVE TREATMENT OF STAGE III-IV ENDOMETRIOSIS - A COMPARISON WITH MEDICAL THERAPY

In this prospective clinical trial, we evaluate the efficacy of combin ed medical and laparoscopic conservative treatment of extensive endome triosis associated with chronic pelvic pain. Thirty-two patients with stage Ill-IV endometriosis allocated to combined medical and laparosco pic surgical treatment were compared with a control group of 20 patien ts with the same characteristics who were given medical treatment alon e. 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 s ignificant difference (P < 0.001) in comparison with the medical treat ment control group. Unfortunately, no conservative treatment of endome triosis 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 result s and is very effective in relieving pain.