Laparoscopic management of endometriomas: a randomized trial versus laparotomy

To demonstrate the advantages of laparoscopic management of endometriomas in comparison with laparotomy, 32 premenopausal nonpregnant women, 18–40 years of age, without acute pelvic symptoms, were prospectively submitted to surgical management of unilateral endometriomas from January 1993 to June 1994 at the Department of Obstetrics and Gynecology of the University of Cagliari, Italy. After abdominal and transvaginal ultrasonographic examination, patients were randomized to have operative laparoscopy (N = 16) or laparotomy (n = 16). The patients were reviewed at the outpatient clinic at 15, 30, 90, and 180 days postoperatively. The intensity of pain was assessed by a visual analog scale at 0, 1, 2, and 3 days postoperatively and comparison was made between the two groups of subjects. The proportions of analgesic-free patients on day 2, of patients discharged from the hospital within day 3, and of patients feeling fully recuperated on day 15 also were compared. The intensity of postoperative pain was significantly lower (p < 0.05) following operative laparoscopy than following laparotomy. A significantly higher proportion (p < 0.05) of patients was analgesic free on day 2, discharged from the hospital within day 3, and feeling fully recuperated on day 15 after operative laparoscopy compared with laparotomy. In conclusion, laparoscopic management of endometriomas may offer to the patients the advantages of reduced postoperative pain and shorter recovery time in comparison with laparotomy