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by claude@2026-06, 2026-06-11
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This review critically examines organ-preserving surgical methods for ovarian endometriomas, emphasizing the impact of cystectomy on ovarian reserve and the limitations of ablation and sclerotherapy, while advocating for dienogest-containing oral contraceptives to prevent recurrence.
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by claude@2026-06, 2026-06-11
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This paper reviews management strategies for ovarian endometriomas in young women, focusing on organ-preserving surgical approaches—cystectomy, ablation, and ethanol sclerotherapy—and on postoperative hormone therapy to reduce recurrence. Based on the authors’ critical synthesis of personal experience and data from recent international publications, the review highlights that cystectomy can be aggressive toward ovarian reserve, while ablation and ethanol sclerotherapy have important limitations. The authors further discuss postoperative recurrence prevention and justify the advantages of combined oral contraceptives containing dienogest, while noting the overall debate and reliance on compiled experience rather than a single new trial. This paper is centrally about endometriosis—specifically ovarian endometrioma surgical strategy and dienogest-containing postoperative hormone therapy to prevent recurrence.
Abstract
For several decades, the problem of ovarian endometriosis has been the focus of attention of scientists all over the globe. However, it remains a relevant issue and is the subject of numerous discussions and debates. One of the key topics in this problem are still the management tactics and strategies for patients with ovarian endometriomas. Generally, these are young women, and their treatment should be aimed at preserving their reproductive potential, which is initially impaired by ovarian endometriosis. Oncological caution and the toxicity of ovarian endometriomas together indicate the need for surgical treatment. From a critical perspective based on personal experience and data from recent international publications, all currently available organ-preserving surgical methods used in patients with ovarian endometriomas are reviewed: cystectomy, ablation, and sclerotherapy. The aggressiveness of cystectomy in relation to ovarian reserve is demonstrated, and the limitations of ablation and ethanol sclerotherapy are emphasized. Special attention is paid to the prevention of postoperative recurrence of ovarian endometriomas, in which hormone therapy plays an important role. In this context, the advantages of combined oral contraceptives containing dienogest are justified. Key words: ovarian endometriosis, endometriomas, cystectomy, ablation, sclerotherapy, recurrence prevention, dienogest
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Ovarian endometrioma. Strategy for surgical treatment and postoperative hormone therapy
Aleksandr I. Davydov /
Victor E. Radzinsky /
Anatoliy I. Ishchenko /
Marina B. Khamoshina /
Raisa A. Chilova /
Mari B. Giorgadze /
Marina B. Khabarova /
Mark F. Dorfman /
For several decades, the problem of ovarian endometriosis has been the focus of attention of scientists all over the globe.
However, it remains a relevant issue and is the subject of numerous discussions and debates. One of the key topics in this problem are still the management tactics and strategies for patients with ovarian endometriomas. Generally, these are young women, and their treatment should be aimed at preserving their reproductive potential, which is initially impaired by ovarian endometriosis. Oncological caution and the toxicity of ovarian endometriomas together indicate the need for surgical treatment. From a critical perspective based on personal experience and data from recent international publications, all currently available organ-preserving surgical methods used in patients with ovarian endometriomas are reviewed: cystectomy, ablation, and sclerotherapy. The aggressiveness of cystectomy in relation to ovarian reserve is demonstrated, and the limitations of ablation and ethanol sclerotherapy are emphasized. Special attention is paid to the prevention of postoperative recurrence of ovarian endometriomas, in which hormone therapy plays an important role. In this context, the advantages of combined oral contraceptives containing dienogest are justified.
Key words: ovarian endometriosis, endometriomas, cystectomy, ablation, sclerotherapy, recurrence prevention, dienogest
For citation: Davydov A.I., Radzinskу V.E., Ishchenko A.I., Khamoshina M.B., Chilova R.A., Giorgadze M.B., Khabarova M.B., Dorfman M.F. Ovarian endometrioma. Strategy for surgical treatment and postoperative hormone therapy. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2025; 24(4): 6–16. (In Russian). DOI: 10.20953/1726-1678-2025-4-6-16
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