Second-look laparoscopy in the treatment of endometriosis

The results of second-look laparoscopy were compared with subjective symptomatology and findings at pelvic exploration in 36 patients who had received conservative treatment for endometriosis. In the 14 patients given pharmacologic treatment, second-look laparoscopy demonstrated active endometriosis in 57.1%, whereas pelvic pain was present in 64.3% and gynecologic examination was positive in 28.6%. In the 22 patients who underwent surgery, active endometriosis was detected by second-look laparoscopy in 31.8%, whereas 40.9% reported pelvic pain and pelvic examination was positive in 31.8%. Thus clinical signs and symptoms were unreliable in the diagnosis of endometriosis recurrence, whereas laparoscopy was indispensable. It should be programmed for 6 months from the end of medical treatment and 12 months after surgery; however, if the pain symptomatology recurs, then laparoscopy is performed immediately.