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document
To excise or ablate endometriosis ? A prospective randomized double-blinded trial after 5-year follow-up . STUDY OBJECTIVE To compare reduction of pain after laparoscopy for ablation or excision of endometriosis . DESIGN Prospective , randomized , double-blind study ( Canadian Task Force classification I ) . SETTING Endometriosis and pelvic pain clinic at a university teaching hospital . PATIENTS Women of reproductive age with pelvic pain and visually proved endometriosis . INTERVENTIONS Subjects completed a questionnaire rating various kinds of pain using visual analog scales ( VAS ) . After visual identification subjects were randomized to treatment via ablation or excision by supervised training gynecologists as primary surgeons . Follow-up questionnaires documented pain levels every 3 months for 1 year and then every 6 months for 5 years . MEASUREMENTS AND MAIN RESULTS Change in pain VAS scores during 5 years after the operation and rates of pregnancy , repeat surgery , and use of hormone therapy were evaluated . There was a reduction in all pain scores over the 5-year follow-up in both treatment groups . A significantly greater reduction in dyspareunia VAS scores was observed in the excision group at 5 years ( p = .03 at univariate analysis , and p = .007 at multivariate analysis ) . More women in the ablation group continued to receive medical treatment of endometriosis at 5 years ( p = .004 ) . CONCLUSIONS Surgical treatment of endometriosis provides symptom reduction for up to 5 years . In some limited areas such as deep dyspareunia , excision is more effective than ablation .
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Intervention_Physical
excise
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Intervention_Educational
or
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Intervention_Physical
ablate
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Intervention_Physical
ablation
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Intervention_Surgical
excision
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Intervention_Educational
questionnaire rating
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Intervention_Physical
ablation
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Intervention_Educational
or
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Intervention_Physical
excision
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Intervention_Surgical
excision
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Intervention_Physical
ablation
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Outcome_Pain
pain levels
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Outcome_Pain
Change in pain VAS scores
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Outcome_Physical
rates of pregnancy
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Outcome_Physical
repeat surgery
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Outcome_Physical
use of hormone therapy
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Outcome_Pain
pain scores
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Outcome_Pain
dyspareunia VAS scores
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Outcome_Physical
medical treatment of endometriosis
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Participant_Condition
endometriosis
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Participant_Condition
Endometriosis
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Participant_Condition
pelvic pain
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Participant_Sex
Women
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Participant_Condition
pelvic pain
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Participant_Condition
endometriosis