Minimal and mild endometriosis remain an enigmatic problem. In contrast with deep infiltrating endometriosis, the milder forms cannot be identified on imaging studies. There are also no reliable biomarkers yet to indicate that a woman has mild endometriosis and whether symptoms are present makes little or no difference. So, for now at least, a laparoscopy, an invasive surgical procedure, is still required to find out if someone has minimal or mild endometriosis.
This raises several questions. Is it reasonable to use a laparoscopy as a screening tool in women at risk (eg. significant family history)? How accurate is visual recognition of minimal or mild lesions during a diagnostic laparoscopy anyway? In the absence of suggestive lesions on MRI or TVUS, is it really in the best interest of the patient to have a diagnostic laparoscopy, even when symptoms are present?
It is known that many lesions seen in the milder forms of endometriosis have a reasonable likelihood of disappearing spontaneously. In this presentation we will take the opportunity to critically analyse the value proposition of the different treatment approaches, including expectant, surgical and medical management of symptomatic minimal and mild endometriosis.