SURGICAL-TREATMENT OF RECURRENT ENDOMETRIOSIS - LAPAROTOMY VERSUS LAPAROSCOPY

The objective of this study was to clarify which is the better surgica l conservative treatment for recurrent endometriosis, We compared two consecutive surgical series at a tertiary care centre for the cure of endometriosis. The patients were 81 women with recurrent endometriosis , 41 reoperated at laparotomy from 1986 to 1991 and 40 reoperated at l aparoscopy from 1992 to 1996, Follow-up after the second operation inc luded clinical and ultrasound examinations performed at least once a y ear to evaluate the recovery of fertility and the reappearance of symp toms and signs of the disease. The cumulative probability of recurrenc e of dysmenorrhoea (34 and 43 respectively), and the frequency of recu rrence of pelvic pain and dyspareunia and of clinical findings suggest ive of the disease were not significantly different in the two groups. The rate of recurrence of dyspareunia was higher in the patients oper ated at laparotomy as was the number requiring a third operation. Howe ver, this could be due to the longer follow-up of this group. No signi ficant difference was observed between the cumulative pregnancy rates at 24 months in the two groups (45 in the laparotomy and 54 in the lap aroscopy group). We conclude that operative laparoscopy seems as effic acious as conservative surgery at laparotomy in the treatment of recur rent endometriosis.