COMBINED TREATMENT OF ENDOMETRIOSIS
Combined treatment for endometriosis involves the use of a course of hormonal treatment before or after surgery.
Who is suitable for combined treatment Combined treatment is sometimes used for women with the more severe forms of endometriosis in association with a conservative laparotomy though it may also be used in combination with a hysterectomy. Laparoscopic surgery is often followed by a course of hormonal treatment regardless of the severity of the condition.
What does combined treatment involve
Gynaecologists vary in the way that they use combined treatment. Some believe that the hormonal treatment is best used before surgery and some believe that it is best used after surgery, while others believe that it can be used both before and after surgery.
Those who recommend that the hormonal treatment be taken before surgery believe that it makes the surgery easier to perform by reducing the size and number of the implants that need to be removed and makes them easier to remove. They also believe that it reduces the development of adhesions following surgery.
The practice of using the hormonal therapy after surgery is based on the thinking that surgery can only remove those implants which are visible and accessible. The hormonal therapy is used to eradicate any implants remaining after surgery, including any microscopic implants.
If the hormonal therapy is used before surgery, two to six months of treatment is usually prescribed, whereas if it is used after surgery up to nine months of treatment is generally used.
Effectiveness of combined treatment
There are few statistics on the benefits of combined treatment. Many gynaecologists believe that combined treatment is probably more effective than hormonal or surgical treatment alone.
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