Retroperitoneal endometriosis infiltrating the utero-sacral ligaments. Technique and results of laparoscopic surgery

The goal of this study is to assess the efficiency of laparoscopic surgical treatment of pain for patients presenting deep endometriosis located on the uterosacral ligaments.

We analysed a continuous series of 36 patients treated by operative laparoscopy between January 1993 and April 1995. In all these cases treatment consisted of resection of all the uterosacral ligament(s) together with exeresis of all other endometriotic lesions.

The results were assessed for all the patients with a minimum follow-up of one year. Patients who presented dysmenorrhea (29 cases) improved in 89.7% of cases (26 patients). Out of the 26 patients who presented deep dyspareunia, improvement was evident for 92.3% of cases (24 patients). The chronic pelvic pain suffered (17 cases) improved in 88.2% of cases (15 patients). Patients who benefited from an improvement rated it excellent or satisfactory in 80% of cases.

These results demonstrate that provided the surgeon is highly skilled in laparoscopy, operative laparoscopy is efficient for the treatment of patients presenting painful symptoms related to deep endometriotic implants located on the uterosacral ligaments.