Reproductive surgery

In: Reconstructive and Reproductive Surgery in Gynecology · 2010 · pp. 259–280 · doi:10.3109/9781841847573-24 · W4231969414
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Excision of endometriotic cyst walls, rather than fenestration and aspiration, improves pain relief, fertility, and reoperation rates, with suturing preferred for hemostasis over electrosurgery.

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Abstract

Prospective study (28) and two randomized trials of removal of the cyst wall versus fenestration and aspiration of cyst contents clearly demonstrate improved results with removal, whether the outcome of interest is pain relief, fertility, or rate of reoperation (29,30). These data, recently supported by a Cochrane review (31), suggest that an excisional approach should be favored in the surgical management of endometriomata. When bleeding is encountered at the site of the excised cyst, data suggest that it is preferable to obtain hemostasis with sutures than with electrosurgery (32).

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