INCIDENCE OF OOPHORECTOMY AT THE TIME OF A PLANNED REMOVAL OF ENDOMETRIOMA IN REPRODUCTIVE AGE WOMEN

Objective: To evaluate the incidence of oophorectomy during planned removal of benign-appearing ovarian endometrioma in reproductive-age women and identify risk factors for intraoperative conversion. Design: Retrospective case-control study at a single tertiary care academic institution Materials and Methods: Medical records from January 2019 to December 2023 were reviewed to identify planned ovarian cystectomies and intraoperative conversions to oophorectomy using CPT codes 58662 and 58925. Inclusion criteria included being 18-45 years of age and the presence of endometrioma; exclusion criteria included malignant-appearing ovarian cyst, concomitant hysterectomy, planned risk-reducing surgery, and planned oophorectomy. Demographic and clinical characteristics were collected. Student’s t-test and Fisher’s exact test were used for statistical analysis, with p<0.05 considered statistically significant. Results: We identified 120 cases of surgical management of ovarian endometriotic cysts. 109 (90.8%) were completed as ovarian cystectomy (cystectomy group), and 11 (9.2%) were converted to oophorectomy (oophorectomy group). Average age and estimated blood loss were higher in the oophorectomy group (p=0.047, p=0.043, respectively), while no significant differences were observed in BMI, race and ethnicity, or endometrioma size (Table 1). Conclusions: This is the first U.S.-based report assessing the intraoperative risk of oophorectomy for planned endometrioma removal. Ovarian cystectomy for endometrioma is one of the most common causes of intraoperative conversion to oophorectomy. Higher intraoperative blood loss and older reproductive age increase the risk of conversion. Additional, multicenter studies are needed to validate our findings and more reliably report the incidence of intraoperative conversion.