Randomised controlled trials (RCTs) of treatment of endometriosis by laparoscopic surgery with or without medical therapy or an adhesion prevention technique were eligible for inclusion. The endometriosis was required to be diagnosed by laparoscopy or histology. Trials that included laparotomy were excluded.
Participants in the included studies were women with pain, infertility, cysts and/or adhesions associated with stage I to IV endometriosis (using American Society for Reproductive Medicine (r-ASRM) criteria). Various laparoscopic interventions were used (for example, excision, ablation, cystectomy, fenestration and coagulation, cyst stripping and adhesion barriers) with or without pre- or post-operative medical treatment (for example, gonadotropin-releasing hormone (GnRH)antagonist, nafarelin, medroxyprogesterone acetate, danazol and levonorgestrel intrauterine system). Interventions were compared with each other and/or with diagnostic surgery alone, placebo, or no treatment.
Outcomes reported in the review included relief of pelvic pain and endometriosis symptoms, pregnancy rates and operative outcomes (for example, ease of surgical procedures, operating time and blood loss). Measures used included visual analogue scales, r-ASRM scales and symptom scores. Duration of follow up ranged from two months to three years.
The authors stated neither how the papers were selected for the review nor how many reviewers performed the selection.