Endometriosis
Recommendations on the surgical treatment of endometrioma
WES has, together with the ESGE and ESHRE, published recommendations on the technical details of how to manage endometrioma surgically.
Endometrioma (ovarian endometriotic cysts) are a commonly diagnosed form of endometriosis – because they are relatively easy and accurately diagnosed by ultrasound.
These ovarian (“chocolate”) cysts frequently present a clinical dilemma when it comes to whether – and how – to treat them when found during imaging or even incidentally during surgery.
Previously published guidelines have provided recommendations based on the best available evidence, but without technical details on the actual management.
A working group of the ESGE, ESHRE, and WES has collaborated in developing recommendations on the practical aspects of endometrioma surgery.
The resulting publication presents general recommendations for surgery of endometrioma and specific recommendations for cystectomy, ablation by laser or by plasma energy, electrocoagulation, as well as a combination of these techniques applied together or with an interval between them.
Watch the tutorial
Resulting from this collaboration a full tutorial is now available – including videos – on the recommendation of the surgical management of endometrioma.
More surgical guidelines to come
Further documents in this series of collaborative surgical recommendations in the treatment of endometriosis will provide recommendations for surgery of deep and peritoneal endometriosis.
Reference
Working group of ESGE, ESHRE, and WES, et al. Recommendations for the surgical treatment of endometriosis – part 1: ovarian endometrioma. Gyn Surg 2017;14: 27 and Hum Reprod Open 2017;4:1-6
Recommendations on the surgical treatment of deep endometriosis
The World Endometriosis Society, together with ESHRE and the ESGE working group, has finalised a second paper [1] in a series of recommendations on the practical aspects of the surgical procedures for the treatment of endometriosis.
The first part of this series on endometrioma surgery (see above) was published in 2017 [2]. This second part focuses on the surgical management of deep endometriosis.
After general considerations such as definitions and anatomical specifications, this publication concentrates on recommendations related to pre-operative management and surgical technique respective of location and extent of disease.
Choices of different treatment options for the treatment of deep endometriosis, and the selection of patients that would benefit from surgery, are beyond the scope of this document. Conservative treatment, including pain management, has to be considered thoroughly.
Full access to the paper and images
References
- Working group of ESGE, ESHRE, and WES, et al. Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis. Hum Reprod Open 2020; doi:10.1093/hropen/hoaa002 and Facts Views Vis Obgyn 2020;11(4):269-297
- Working group of ESGE, ESHRE, and WES, et al. Recommendations for the surgical treatment of endometriosis. Part 1: endometrioma. Gyn Surg 2017;14:27 and Hum Reprod Open 2017;4:1-6