Objective: To outline the appropriate management of patients with endometriosis and pelvic pain recurrence using surgical management with and without hormonal assistance. Data Sources: Sources include original articles and reviews on etiology and clinical presentation, current classification systems, and surgical techniques ranging from laparoscopic identification to radical resection of endometriosis. All technical sources were written from 1987 to the present. Methods of Study Selection: Hormonal and surgical management reviews currently used are standard of care in the treatment of endometriosis. Twenty-eight review articles emphasizing clinical presentation, histologic correlation to subtypes of disease, and alleviation of pain and symptoms with surgical intervention were used to compile this management strategy, Data Extraction and Synthesis: All methods reviewed and outlined constitute appropriate standard of care in the treatment of pelvic pain and endometriosis, In addition, articles addressing the reclassification of endometriosis and its subtypes were utilized. Conclusions: The multiple presentations of endometriosis and the histologic correlation indicate subtypes of disease. While medical management may be beneficial to some patients with endometriosis, it is at best temporizing for those patients with recurrent pelvic pain. Although there is no cure for endometriosis, carefully selected and appropriate surgical management in the face of recurrent pelvic pain remains the mainstay of treatment.
