Treatment with medications or hormones has been generally disappointing in the treatment of endometriosis. Hormones that suppress the menstrual cycle are often quite effective at controlling symptoms, but they do not permanently eliminate endometriosis and do not improve fertility. Keyhole or laparoscopic surgery is now the cornerstone of endometriosis treatment. Endometriotic deposits, particularly those causing severe pain are often deep seated and invasive. The most effective treatment for these deposits is surgical excision. This surgery is more precise when carried out with the magnification of the laparoscope, which also affords a more rapid recovery. Surgical treatment has also been shown in randomised studies to improve fertilty.

Deposits of endometriosis can often be deep seated and surrounded by considerable scarring and adhesions to organs such as bladder and bowel. There can be some risks of causing damage to the surrounding organs if endometriosis is severe. The benefits of endometriosis excision usually justify these risks if symptoms are severe. We try and minimize these risks and sometimes this involves emptying the bowel prior to surgery (bowel preparation). Occasionally endometriosis can be very severe and may involve the bowel. Occasionally it may be necessary to resect a section of bowel to adequately treat the endometriosis. This may involve a temporary colostomy. Some women who have severe symptoms of endometriosis, and have completed their family, may require a hysterectomy to completely relieve their symptoms. In most cases this can be carried out through keyhole surgery.