Surgically treated patients recover from their laparoscopic procedure in 1-2 weeks. Laparoscopic treatment of endometriosis may sometimes be combined with medical therapy involving progesterone or GnRH agonists. This combination is most often used in the patient who is not currently attempting pregnancy, but plans to do so in the next 1 to 2 years. Postoperative medical treatment may be indicated if the disease has not been completely resected, for treatment of microscopic or metastatic disease, or for treatment of pain unrelieved by surgery. Preoperative or postoperative treatment is usually given for 2 to 6 months.
Many patients prefer no treatment, or medical treatment before surgery.
However, surgery is often the most appropriate approach. Laparoscopy is generally the preferred surgical approach, but laparotomymay be appropriate for rare cases, especially those requiring bowel resection. It is critical that physicians recognize the degree to which endometriosis can physically and emotionally disrupt patients' lives. Patients can better understand the condition, its implications, and appropriate treatment through information obtained from organizations such as the Endometriosis Association, Resolve, and the American Society for Reproductive Medicine. Personal or group counseling may also be helpful, especially for the patient with chronic pain.