Deep endometriosis often requires surgical treatment, but because it is more invasive, clear indications for surgery are needed before surgery can be scheduled. Patients currently being considered for surgery include those whose painful symptoms have failed to respond to medication; those with increased localised lesions, combined ovarian-type endometriosis and/or infertility; those with obstruction or dysfunction due to invasion of organs such as the bowel and ureter; those with malignant pelvic lesions that cannot be excluded; and those with persistent lesions after menopause.