By David B Redwine MD, David B. Redwine

Endometriosis Institute of Oregon, Bend. Covers the surgical administration of endometriosis. additionally positive aspects laparoscopic suggestions and plentiful full-color images and illustrations. contains such issues because the rules of monopolar electrosurgery, excision of endometriosis, ovarian endometriosis, and extra. For physicians.

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No references were offered in support of their opinions. None of the above studies showed actual destruction of endometriosis resulting from decreased estrogen effect, but relied on symptomatology to gauge success of treatment. As with pregnancy, absence or diminution of symptoms does not prove elimination of disease. Probably because endometriosis is less symptomatic after the menopause, and because fewer menopausal patients seek treatment for it, not as much is known about the disease in postmenopausal patients as following pregnancy.

McArthur JW, Ulfelder H. The effect of pregnancy upon endometriosis. Obstet Gynecol Surv 1965; 20:709–33. Surgical management of endometriosis 22 25. Hanton EM, Malkasian GD, Dockerty MB, Pratt JH. Endometriosis: symptomatic during pregnancy. Am J Obstet Gynecol 1966; 95: 1165–6. 26. Norenberg DD, Gundersen JH, Janis JF, Gundersen AL. Early pregnancy on the diaphragm with endometriosis. Obstet Gynecol 1977; 49:620–2. 27. Sampson JA. Heterotopic or misplaced endometrial tissue. Am J Obstet Gynecol 1925; 10:649– 64.

However, this subgroup is thus far unidentified; advocates should focus future trials upon somehow stratifying endometriosis patients and then randomized to drug versus no treatment. Until that time, it is clear that these medications play no role in the treatment of endometriosisassociated infertility. Of the experimental treatment for endometriosis, only pentoxifylline has been investigated as a treatment for endometriosisassociated infertility. This drug has the advantage of not inhibiting ovulation and thus can be utilized without delay of attempted conception.

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