Follow-up report on a randomized controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal to moderate endometriosis.

OBJECTIVE

To assess the longer term efficacy of laparoscopic laser surgery in the treatment of painful pelvic endometriosis and to observe the natural history of the disease at second-look laparoscopy in a control group.

DESIGN

One-year follow-up of a prospective, randomized, double-blind controlled trial.

SETTING

A referral center for the laparoscopic laser treatment of endometriosis.

PATIENT(S): Sixty-three patients with pelvic pain and minimal to moderate endometriosis.

INTERVENTION(S): After the 6-month follow-up visit, the randomization code was broken, and follow-up was continued to 1 year. Symptomatic patients were offered second-look laser laparoscopy.

MAIN OUTCOME MEASURE(S): Continued symptom relief at 1 year after treatment and findings at second-look laparoscopy in symptomatic controls.

RESULT(S): Symptom relief continued at 1 year in 90% of those who initially responded. All symptomatic controls had a second-look procedure, with 7 (29%) showing disease progression, 7 (29%) showing disease regression, and 10 (42%) having static disease.

CONCLUSION(S): The benefits of laser laparoscopy for painful pelvic endometriosis are continued in the majority of patients at 1 year. Untreated painful endometriosis will progress or remain static in the majority of patients but will spontaneously improve in others.