Laparoscopy Benefits Women With Endometriosis Across All Stages
Sep 26, 2025
Study Confirms Laparoscopy as an Effective Treatment for Pain Across Endometriosis Subtypes
Key Points
Highlights:
- Laparoscopic surgery significantly reduced pain severity and improved quality of life (QoL), including better emotional well-being, improved social support, and a stronger sense of control in women with endometriosis.
- Benefits were observed across all subtypes and stages, including stage IV disease.
Importance:
- Laparoscopic excision of endometriosis provides consistent symptom relief and QoL improvements, regardless of disease severity.
- The findings support laparoscopy as an effective treatment option for women with debilitating pain and impaired daily functioning due to endometriosis.
What’s done here:
- A follow-up study of 50 women with surgically confirmed endometriosis treated at Amir Al Momenin Hospital, Zabol, Iran.
- Participants had severe pain, poor QoL, or infertility unresponsive to ART.
- Women were classified into stage IV and stage I–III subgroups using ASRM criteria.
- Pain severity was measured using the visual analog score (VAS), and QoL was assessed using the Endometriosis Health Profile-30 (EHP-30) questionnaire.
- Outcomes were tracked at baseline, 3, 6, and 12 months post-surgery.
Key results:
- Pain scores decreased significantly in both groups:
- Stage IV: from 8.5 to 2.3 at 12 months (p < 0.0001).
- Stages I–III: from 8.9 to 2.7 at 12 months (p < 0.0001).
- QoL scores also improved significantly in both groups:
- Stage IV: from 59.4 to 25.8 (p < 0.0001).
- Stages I–III: from 54.6 to 30.3 (p < 0.0001).
- No statistically significant differences were found between stage IV and lower-stage patients in the magnitude of improvement.
Limitations:
- Small sample size (n=50) and single-center design that limit generalizability; short follow-up period (12 months); lack of subgroup analysis for specific lesion types (deep, endometrioma, superficial) or adhesions are the main limitations.
From the Editor-in-Chief – EndoNews
"This study reinforces the value of laparoscopic excision as a cornerstone in the management of endometriosis-associated pain. By demonstrating significant and sustained improvements in both pain severity and quality of life, regardless of disease stage, the authors challenge the assumption that advanced disease predicts poorer outcomes. Importantly, quality of life gains extended beyond symptom relief to include emotional well-being, social functioning, and self-perception, underscoring the holistic benefits of surgical treatment.
Although the sample size was modest and follow-up limited to 12 months, the findings align with a growing body of evidence supporting laparoscopic surgery as a reliable option for women with severe, refractory pain. The results highlight the need for larger multicenter studies with longer follow-up to refine patient selection, assess recurrence, and better integrate surgical outcomes into long-term care pathways. Until then, this study provides compelling evidence that laparoscopic management can deliver meaningful improvements for women across the full spectrum of endometriosis severity."
Lay Summary
Endometriosis greatly affects daily life and emotional well-being. Many women experience severe pelvic pain, fatigue, and reduced quality of life.
Laparoscopic surgery, a minimally invasive operation that removes endometriosis lesions, is often offered when medications no longer help.
In this study, published in the International Journal of Reproductive BioMedicine, Dr.Sadeki from Zabol University of Medical Sciences and Iran University of Medical Sciences followed 50 women with endometriosis who underwent laparoscopic surgery.
Half of the women had severe (stage IV) disease, and half had milder stages (I–III). Researchers measured both pain severity and quality of life before surgery and then again at 3, 6, and 12 months after surgery.
The results showed that pain improved dramatically in all women after surgery, regardless of how severe their disease was.
Quality of life scores also improved, with women reporting better emotional health, more social support, and a stronger sense of control over their condition.
Furthermore, improvements were maintained over the 12-month follow-up period, and women with advanced disease benefitted just as much as those with milder forms.
This means that laparoscopic surgery can provide meaningful relief for women with endometriosis across all disease stages.
Although the study was relatively small and only followed patients for one year, it adds to the evidence that surgery not only reduces pain but also helps women regain a better quality of life.
