Catenacci Michelle, Sastry Suchetha, Falcone Tommaso
The Cleveland Clinic, Department of Obstetrics and Gynecology, 9500 Euclid Avenue, Cleveland, OH, USA.
Clin Obstet Gynecol. 2009 Sep;52(3):351-61. doi: 10.1097/GRF.0b013e3181b08cc3.
Endometriosis is a leading cause of pelvic pain and infertility in women. Laparoscopy can both diagnose and treat this disease. The aim of this review was to examine current literature on treatments for endometriosis for both pain and infertility. Evidence supports removal of severe disease, including ovarian endometriomas, for improved pregnancy outcomes. However, for patients that fail initial surgery, in vitro fertilization may yield superior outcomes over repeat surgery. For pelvic pain, surgery has been shown to improve symptoms although there is a significant placebo effect with surgery. Finally, hysterectomy can be offered to women who fail initial conservative surgery.
子宫内膜异位症是女性盆腔疼痛和不孕的主要原因。腹腔镜检查可用于诊断和治疗这种疾病。本综述的目的是研究当前关于子宫内膜异位症疼痛和不孕治疗的文献。有证据支持切除严重病变,包括卵巢子宫内膜异位囊肿,以改善妊娠结局。然而,对于初次手术失败的患者,体外受精可能比再次手术产生更好的效果。对于盆腔疼痛,手术已被证明可改善症状,尽管手术存在显著的安慰剂效应。最后,对于初次保守手术失败的女性,可以考虑进行子宫切除术。