Identifying the problems of randomized controlled trials for the surgical management of endometriosis associated pelvic pain

ConclusionSurgical RCTs have always been difficult to undertake, yet there are 16 RCTs in the area of endometriosis-associated pain. Ethical considerations, the equipoise of surgeons and participants and follow-up duration are all important parameters in establishing RCTs. We must also be willing to accept and adopt the evidence when it does demonstrate a particular outcome – such as the fact that surgical uterosacral nerve disruption does not improve pain, or that disc excision does not substantially reduce complications compared to segmental resection for bowel disease as prior non-randomized studies suggested. If we accept that the well-conducted RCT provides the best quality evidence, then we should at least be open to the possibility that our long-held views may be challenged and changed with new science in our practice.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research