COMPARISON OF CO2-LASER LAPAROSCOPY WITH LAPAROTOMY FOR TREATMENT OF ENDOMETRIOMATA

Objective: To assess the effectiveness of laparoscopy versus laparotomy in the treatment of endometriomata. Design: Controlled study using data prospectively tabulated. Setting: Treatment performed by senior author in a referral reproductive endocrinology and surgery private practice. Patients: One hundred infertile women were diagnosed with endometriomata. Intervention: Forty-eight women were treated with C02 laser laparoscopy (laparoscopy group) and 52 women were treated with C02 laser or nonlaser laparotomy (laparotomy group). Main Outcome Measure: The hypothesis that laparoscopy group pregnancy rates (PRs) would be equal to or greater than laparotomy group was formulated before data analysis but after data tabulation. Results: The 1 and 3-year life table estimated cumulative PRs +/- SE were 0.30 +/- 0.07 and 0.52 +/- 0.09 for laparoscopy group and 0.23 +/- 0.06 and 0.46 +/- 0.09 for laparotomy group (Breslow P = 0.48). Monthly fecundity over 3 years was 2.4% for laparoscopy group and 2.0% for laparotomy group. Conclusions: Laparoscopy with CO2 laser can be a safe and effective modality for treating endometriomata.