PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND, CONTROLLED TRIAL OF LASER LAPAROSCOPY IN THE TREATMENT OF PELVIC PAIN ASSOCIATED WITH MINIMAL, MILD,AND MODERATE ENDOMETRIOSIS
Cjg. Sutton et al., PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND, CONTROLLED TRIAL OF LASER LAPAROSCOPY IN THE TREATMENT OF PELVIC PAIN ASSOCIATED WITH MINIMAL, MILD,AND MODERATE ENDOMETRIOSIS, Fertility and sterility, 62(4), 1994, pp. 696-700
Objective: To assess the efficacy of laser laparoscopic surgery in the
treatment of pain associated with minimal, mild, and moderate endomet
riosis. Design: A prospective, randomized, double-blind, and controlle
d clinical study. Setting: Royal Surrey County Hospital, Guildford, Un
ited Kingdom, a referral center for the laser laparoscopic treatment o
f endometriosis. Patients: Sixty-three patients with pain (dysmenorrho
ea, pelvic pain, or dyspareunia) and minimal to moderate endometriosis
. Interventions: The patients were randomized at the time of laparosco
py to laser ablation of endometriotic deposits and laparoscopic uterin
e nerve ablation or expectant management. Pain symptoms were recorded
subjectively and by visual analogue scale. The women were unaware of t
he treatment allocated as was the nurse who assessed them at 3 and 6 m
onths after surgery. Main Outcome Measure: Improvement or resolution o
f pain symptoms assessed subjectively and by visual analogue score. Re
sults: Laser laparoscopy results in statistically significant pain rel
ief compared with expectant management at 6 months after surgery. Sixt
y-two and a half percent of the lasered patients reported improvement
or resolution of symptoms compared with 22.6% in the expectant group.
Results were poorest for minimal disease and, if patients with mild an
d moderate disease only are included, 73.7% of patients achieved pain
relief. There were no operative or laser complications. Conclusions: L
aser laparoscopy is a safe, simple, and effective treatment in allevia
ting pain symptoms in women with stages I, II, and III endometriosis.