{"paper_id":"43d1379d-0486-4b48-a934-f43e243b8b2b","body_text":"Abstract\nPurpose\nTo compare two different surgical techniques, stripping or cystectomy, in patients treated with the same post-operative medical therapy in terms of recurrence of endometrioma, recurrence of pain and spontaneous pregnancy rate within 2 years from surgery.\nMethods\nThe inclusion criteria of this study were: (1) 25–40 years old; (2) ovarian endometrioma more than 3 cm of diameter detected by transvaginal ultrasonography (3) regular menstrual cycle (4) post-operative treatment with GnRH analogs, (5) tubal patency assessed by laparoscopic chromopertubation (6) normal human semen characteristics. Exclusion criteria were uterine myoma, previous medical treatment for endometriosis, presence of adenomyosis, previous surgery of ovarian endometrioma, multiple cysts, bilateral involvement, co-existence of deep endometriosis. Patients were assigned to two study groups: group A (N = 45) patients undergoing stripping technique and group B (N = 64) patients undergoing cystectomy technique for ovarian endometrioma.\nResults\nIn group B the percentage of ultrasonographic recurrence (15.4 %, N = 15) is much lower than in group A (55.6 %, N = 25). (p value 0.001). In group B the percentage of symptomatic recurrence (21.8 %, N = 14) is much lower than in group A (53.3 %, N = 24) (p value 0.001). Spontaneous pregnancy rate in group A patients was of 4.4 % (N = 2) and in group B 22.3 % (N = 21), (p value 0.0072). However, the percentage of specimen with adjacent healthy ovarian tissue was lower in group A (26.6 %) than in group B (50 %) (p value 0.01).\nConclusions\nAmong the different treatment options for surgical treatment of ovarian endometrioma, in our experience cystectomy appears to be the most appropriate treatment, both in terms of recurrence and pregnancy rate.\nSimilar content being viewed by others\nReferences\nYuen PM, Yu KM, Yip SK, Lau WC, Rogers MS, Chang A (1997) A randomized prospective study of laparoscopy and laparotomy in the management of benign ovarian masses. Am J Obstet Gynecol 177:109–114\nDonnez J, Nisolle M, Gillet N, Smets M, Bassil S, Casanas-Roux F (1996) Large ovarian endometriomas. Hum Reprod 11:641–646\nLuciano AA, Maier DB, Koch EI, Nulsen JC, Whitman GF (1989) A comparative study of postoperative adhesions following laser surgery by laparoscopy versus laparotomy in the rabbit model. 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Fertil Steril 95:2247–2250\nYu HT, Huang HY, Soong YK, Lee CL, Chao A, Wang CJ (2010) Laparoscopic ovarian cystectomy of endometriomas: surgeons’ experience may affect ovarian reserve and live-born rate in infertile patients with in vitro fertilization intracytoplasmic sperm injection. Eur J Obstet Gynecol Reprod Biol 152:172–175\nConflict of interest\nThe authors declare that they have no conflict of interest.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nMoscarini, M., Milazzo, G.N., Assorgi, C. et al. Ovarian stripping versus cystectomy: recurrence of endometriosis and pregnancy rate. Arch Gynecol Obstet 290, 163–167 (2014). https://doi.org/10.1007/s00404-014-3158-z\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-014-3158-z","source_license":"public-domain-us","license_restricted":false}