Patterns of and Risk Factors for Recurrence in Women With Ovarian Endometriomas

Xishi Liu, Lei Yuan, Fanghua Shen, Zhilin Zhu, Hongyuan Jiang, Sun-Wei Guo, Sun‐Wei Guo
Obstetrics and gynecology · 2007 · vol. 109(6) , pp. 1411–1420 · doi:10.1097/01.aog.0000265215.87717.8b · PMID:17540815 · W2036822839
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This study identified the revised American Fertility Society score, younger age, and prior medical treatment as risk factors for endometrioma recurrence, and the rAFS score for dysmenorrhea recurrence, with a constant hazard rate for the first 28-30 months post-surgery.

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Abstract

OBJECTIVE: To identify risk factors for and the patterns of recurrence of endometrioma and of dysmenorrhea in women with ovarian endometrioma. METHODS: We evaluated 710 consecutive patients operated on for ovarian endometriomas who were followed up for an average of 22.4 months. Twenty factors were examined to assess their effect on risk of recurrence of endometrioma and of dysmenorrhea using survival analysis. Hazard rate also was estimated to examine recurrence patterns. RESULTS: For recurrence of endometrioma, the revised American Fertility Society (rAFS) score, younger age at surgery, and previous medical treatment of endometriosis were identified to be risk factors. For recurrence of dysmenorrhea, rAFS score was the only risk factor. For both recurrences, there was a constant hazard rate in the first 28-30 months after surgery, indicating that the recurrence in that period is completely random. After that period, the hazard rate increased dramatically. CONCLUSION: The total rAFS score, but not rAFS stage, is a risk factor for recurrence of both endometrioma and dysmenorrhea, indicating that the rAFS stage has little prognostic value. The existence of a completely random recurrence period may be a universal phenomenon, with its duration and the magnitude of recurrence risk determined by patient characteristics and quality of care. The second phase of much higher recurrence risk may reflect successful reseeding, reimplantation, and regrowth of ectopic endometrium. Therefore, the identification of risk factors as well as patterns of recurrence should shed better light on possible causes for recurrence, which is now poorly understood.

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Condition tags

mesh:D004412mesh:D004715endometriosisendometriomadysmenorrhea

MeSH descriptors

Dysmenorrhea Endometriosis Ovarian Diseases Adolescent Adult Age Factors Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Female Follow-Up Studies Humans Laparoscopy Middle Aged Ovarian Diseases Ovarian Diseases Postoperative Period Prognosis Reoperation

Citation neighborhood

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