To compare the clinical characteristics and treatment of different kinds of endometrioma

Objective To investigate the clinical characteristics,surgical effectiveness and postoperative recurrence rate among different kinds of endometrioma.Methods A total of 600 patients undergoing laparoscopic ovarian endometrioma excision between March 2003 and March 2008 were studied retrospectively.All patients were classified into four groups according to the combined disease:none(simple group),adenomyosis(AM group),deep infiltrating endometriosis(DIE group),combined with two kinds of disease mentioned above(mixed group).The associated factors of different groups of endometrioma were analyzed.Results(1)The patient rate above 35 years of AM group was 64.2%,which was significantly higher than simple group(36.0%)and DIE group(26.8%).(2)Different groups of endometrioma were associated with severity of pain symptoms and duration of dysmenorrhea.Moderate-to-severe dysmenorrhea rate among DIE group,AM group and mixed group were 69.0%,79.2%,83.3%,respectively,which was higher than simple group(51.7%).Compared with simple group,longer dysmenorrhea duration was observed in other groups.(3)Endometrioma combined with other diseases resulted in longer operation time and more blood loss(P0.05).(4)Infertility rate was higher in AM group than in other groups(OR=2.187,P=0.011,30.2%vs16.9%).Postoperative pregnant rate of AM group was lower than other groups(OR=0.116,P=0.02,0 vs 39.0%).(5)Pain relief rate of AM group was lower than the other groups(OR=2.250,P=0.044,17.9% vs 8.8%).(6)Multivariate logistic regression analysis:the associated multi-factors of endometrioma with adenomyosis or deep infiltrating endometriosis were:age,dysmenorrhea,and operation time.Conclusions Endometrioma patients combined with adenomyosis or deep infiltrating endometriosis have more severe pelvic pain symptoms,less surgical effectiveness and lower post-operative pain relief rate.