Outcome of conservative surgical treatment of deep infiltrating endometriosis

Deep infiltrating endometriosis, which is frequently associated with pain, is diagnosed at clinical examination and with indirect imaging techniques like ultrasound and MRI. The aim of this study was to evaluate complications and recurrence rate after laparoscopic resection of deep infiltrating endometriosis by shaving technique. Between January 2004 and December 2010, 74 procedures for deep infiltrating endometriosis were performed in patients with pain and/or infertility. The endometriotic plaques were resected laparoscopically using scissors and bipolar and/or unipolar current. If rectosigmoidal invasion was present, a shaving was performed. Mean age was 31.7 years (SD ± 4.4). The vaginal nodule was a solitary lesion in 4 % of the patients without involvement of the ovaries, rectum or bladder. In 86 % of the cases, the rectosigmoid was involved as well. Mean follow-up was 776 days (SD = 465). One patient developed postoperatively a severe complication with intestinal perforation secondary to thermal necrosis (1.4 %). In four patients recurrence of symptoms was noted (8 %). Conservative surgery for deep infiltrating endometriosis resulted in the relief of pain, with a low postoperative complication rate (1.4 %). This shaving technique also resulted in a limited risk of recurrence of the symptoms (8 %).