FOLLOW-UP REPORT ON A RANDOMIZED CONTROLLED TRIAL OF LASER LAPAROSCOPY IN THE TREATMENT OF PELVIC PAIN ASSOCIATED WITH MINIMAL TO MODERATE ENDOMETRIOSIS

Objective: To assess the longer term efficacy of laparoscopic laser su rgery in the treatment of painful pelvic endometriosis and to observe the natural history of the disease at second-look laparoscopy in a con trol group. Design: One-year follow-up of a prospective, randomized, d ouble-blind controlled trial. Setting: A referral center for the lapar oscopic laser treatment of endometriosis. Patient(s): Sixty-three pati ents with pelvic pain and minimal to moderate endometriosis. Intervent ion(s): After the 6-month follow-up visit, the randomization code was broken, and follow-up was continued to 1 year, Symptomatic patients we re offered second-look laser laparoscopy. Main Outcome Measure(s): Con tinued symptom relief at 1 year after treatment and findings at second -look laparoscopy in symptomatic centrals. Result(s): Symptom relief c ontinued at 1 year in 90% of those who initially responded. All sympto matic controls had a second-look procedure, with 7 (29%) showing disea se progression, 7 (29%) showing disease regression, and 10 (42%) havin g static disease. Conclusion(s): The benefits of laser laparoscopy for painful pelvic endometriosis are continued in the majority of patient s at 1 year. Untreated painful endometriosis will pr ogress or remain static in the majority of patients but will spontaneously improve in o thers. (C) 1997 by American Society for Reproductive Medicine.