Two options, same relief in mild endometriosis.(Gynecology)

LONDON -- Patients with chronic pelvic pain and mild endometriosis can get temporary relief from excision or ablation of their lesions almost 70% of the time, according to a randomized controlled trial of both treatments.

"If you look at patients who have purely superficial lesions, not patients with infiltrating disease or ovarian cysts, regardless of which treatment, 67% will report pain relief 6 months after the procedure," said principal investigator Jeremy T. Wright, M.B., president of the British Society for Gynaecological Endoscopy, and a consultant gynecologist at Woking (England) Nuffield Hospital and Ashford and St Peter's Hospitals NHS Trust, Chertsey, England.

The study, which Dr. Wright reported at the annual congress of the International Society for Gynecologic Endoscopy, included 22 chronic pelvic pain patients with mild endometriosis, meaning they had revised American Fertility Society scores of 1-2. The patients were randomized at the time of laparoscopy to either excision of the lesions or ablation using monopolar diathermy.

Before the procedure, participants in the study were asked to complete a symptom questionnaire that included a pain rating. Specific areas of pelvic tenderness also were identified and rated. This evaluation was then repeated at 6 months post procedure, at which time participants and investigators were blinded to the treatment modality.

At 6 months, both treatments apparently produced good symptomatic relief and reduction of pelvic tenderness in most patients. Two patients in the ablation group reported no relief, or a worsening of symptoms or signs, but this was not significant statistically, according to Dr. Wright.

In addition, two patients involved in the study--one from each treatment group--became pregnant during the follow-up period.

"These findings show that at diagnostic laparoscopy, ...