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[17] [21] Surgical interventions are considered when: Medical management fails to control symptoms adequately Fertility is a primary concern Endometriomas (ovarian cysts) or severe adhesions are present Deep infiltrating endometriosis affects bowel or bladder Laparoscopic excision or ablation of endometriotic lesions, performed in specialist endometriosis centres, can provide significant symptom relief

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10.3389/fendo.2023.1281107 117 SpitlerK

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13 , e1005758 (2017)