Is laparoscopy necessary for diagnosing and treating endometriosis?
Laparoscopy is the only way of diagnosing endometriosis, however it is only one part of treatment process of endometriosis and its associated pelvic pain. Endometriosis often recurs and requires multi-modal treatment even after a laparoscopic treatment.
What other treatments are there available for endometriosis?
Other treatments may include:
- non-hormonal medications to treat pain such as:
- anti-inflammatory analgesia
- or pain modulators (in cases when the pain is chronic)
- hormonal medications such as:
- the contraceptive pills
- or progesterone (oral progesterone or progesterone containing intrauterine device such as Mirena
- to control or stop menstrual periods
- to suppress the growth of endometriosis
- specialist pelvic floor physiotherapy
- staying as healthy as possible – this includes doing gentle exercises, having enough sleep, and findings ways to manage stress
How is endometriosis treated at a laparoscopy?
The pelvis and pelvic organs are examined for presence of endometriosis or adhesions during a laparoscopy. If endometriosis is found, the decision to proceed and treat the endometriosis is made.
The type of treatment includes:
- diathermy of endometriosis – burning the endometriotic implants to destroy the abnormal endometriotic implants
- excision of endometriosis – removing the endometriotic implants. Excision is more effective than diathermy in deep-infiltrating endometriosis
If endometriosis cyst is found in the ovary (endometrioma/ chocolate cyst), it should be excised (removed) completely rather than just drained, to reduce the chance of recurrence.
Who should be performing your laparoscopy to treat endometriosis?
Laparoscopic treatment of endometriosis should be performed by specialist gynaecologists who have completed additional training either in minimally invasive gynaecology surgery, or in surgical gynaecological oncology in order to learn techniques and procedures to complete the most complex surgeries with lower complication rates. They also perform higher volume of more complex cases.
Link to AGES Patient Information Video on Laparoscopic Treatment of Endometriosis.