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Surgery is recommended when medical hormonal therapy fails to alleviate symptoms or for specific clinical scenarios:

: Persistent pain (dysmenorrhea, dyspareunia) that does not respond to medical treatment. Download Chirurgie l'endomГ©triose pdf

: When lesions affect vital organs like the bowel, bladder, or ureters, surgery aims to restore organ function. Surgery is recommended when medical hormonal therapy fails

: Operative laparoscopy is effective for stages I/II to improve spontaneous pregnancy rates by reducing local inflammation. 2. Core Surgical Techniques ESHRE guideline: endometriosis - PMC Download Chirurgie l'endomГ©triose pdf

The paper on (Endometriosis Surgery) focuses on the transition from surgery as a first-line treatment to a targeted intervention used primarily for drug-resistant pain or fertility optimization. 1. Indications for Surgical Intervention

: Ovarian cysts larger than 4–6 cm generally require surgical removal to prevent rupture or complications.