The treatment of endometriosis can be broadly defined into two categories: medical and surgical. Medical treatment involves the use of medications which function by manipulating hormone levels, however they merely suppresses the pain of endometriosis whilst worsening the infertility. Only surgical treatment offers the prospect of a ‘cure’ of endometriosis in terms of a long term reduction or elimination of pain and an increase in fertility. Surgical treatment of endometriosis should be performed via laparoscopy (keyhole surgery), and not laparotomy (open surgery) as it offers numerous advantages to the patient. The most effective means of surgical treatment of endometriosis is via ‘excision’ and Mr. Trehan has innovated an extension of this technique, ‘Total Pelvic Peritoneal Excision’ in order to improve the outcome of surgical treatment in terms of pain, fertility and disease recurrence. Mr. Trehan’s view is that the ovaries should not be removed under any circumstances in the treatment of endometriosis.
In depth discussions of the mechanisms and merits of medical and surgical treatment can be viewed using the two links below: