Clinical and surgical aspects of ovarian endometriotic cysts

H Egger, P Weigmann
Archives of gynecology · 1982 · doi:10.1007/BF02110677 · PMID:6762166
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This retrospective study of 263 endometriotic ovarian cyst patients found frequent co-occurring pathologies, variable clinical presentation, low recurrence after conservative surgery, and a low risk of carcinoma or oviductal complications.

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This paper analyzed case histories of 263 patients with histologically confirmed ovarian endometriotic cysts (1962–1979), focusing on clinical presentation and surgical observations from admission through laparotomy and conservative surgery outcomes. It found that diagnosis frequency increased over time, most patients were 35–39 years old, and the admission diagnosis was rarely recognized as endometriosis, with clinical picture and extent of disease showing little correlation. At laparotomy, spontaneous rupture occurred in 12% and rupture during surgery in about half of cases without adverse postoperative effects; recurrence after conservative surgery was 7%, with accompanying uterine fibroids and adenomyosis each reported in 42%. Infection as isolated ovarian abscess occurred in 8–18%, malignancy risk was under 1%, and only limited correlation between symptoms and disease extent was noted as a caveat, with the cohort drawn from an earlier time period (1962–1979). This paper is centrally about endometriosis — it specifically examines clinical and surgical aspects of ovarian endometriotic cysts.

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Abstract

The case histories of 263 patients with histologically proven endometriotic cysts of the ovaries (1962-1979) were studied. The diagnosis frequency increased continuously during the observation period. Most patients were aged 35-39 years. The admission diagnosis was rarely endometriosis. The clinical picture and the extent of the disease rarely showed correlation. At laparotomy 12% of the chocolate cysts had ruptured spontaneously (31 of 263) and half of the cysts ruptured during surgery without adverse effects on the postoperative course. The recurrence rate in patients treated by conservative surgery was 7%. The most frequent accompanying diseases were uterine fibroids (42%) and adenomyosis (42%). One third of the patients presented with bilateral endometriotic cysts. Further foci of endometriosis tissue were frequently found in the affected ovary (55%) and in the other pelvic organs (43%). Only 4% of the ipsilateral oviducts were closed at their fimbrial end, and only 10% showed signs of endosalpingitis. The incidence of infection in endometriotic cysts--formation of an isolated ovarian abscess--was between 8% and 18%, while the risk of carcinoma was less than 1%.
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Summary The case histories of 263 patients with histologically proven endometriotic cysts of the ovaries (1962–1979) were studied. The diagnosis frequency increased continuously during the observation period. Most patients were aged 35–39 years. The admission diagnosis was rarely endometriosis. The clinical picture and the extent of the disease rarely showed correlation. At laparotomy 12% of the chocolate cysts had ruptured spontaneously (31 of 263) and half of the cysts ruptured during surgery without adverse effects on the postoperative course. The recurrence rate in patients treated by conservative surgery was 7%. The most frequent accompanying diseases were uterine fibroids (42%) and adenomyosis (42%). One third of the patients presented with bilateral endometriotic cysts. Further foci of endometriosis tissue were frequently found in the affected ovary (55%) and in the other pelvic organs (43%). Only 4% of the ipsilateral oviducts were closed at their fimbrial end, and only 10% showed signs of endosalpingitis. The incidence of infection in endometriotic cysts — formation of an isolated ovarian abscess — was between 8% and 18%, while the risk of carcinoma was less than 1%. Similar content being viewed by others References Beyth Y, Yaffe H, Levij J, Sadovsky E (1975) Retrograde seeding of endometrium: a sequela of tubal flushing. Fertil Steril 26: 1094 Buttram VC (1979) Conservative surgery for endometriosis in the infertile female. Fertil Steril 31: 117 Corner GW, Hu C, Hertig AT (1950) Ovarian carcinoma arising in endometriosis. Am J Obstet Gynecol 59: 760 Czernobilsky B, Silverman BB, Mikuta JJ (1970) Endometrioid carcinoma of the ovary. Cancer 26: 1141 DaCosta CC (1948) Extragenital locations of endometriosis. Am J Obstet Gynecol 55: 182 DaCosta CC (1948) Endometriosis outside the uterus. 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Am J Obstet Gynecol 129: 245 Weigmann P (1981) Die zystische Ovarialendometriose. Inaug. Dissertation, Universität Erlangen-Nürnberg Author information Authors and Affiliations Rights and permissions About this article Cite this article Egger, H., Weigmann, P. Clinical and surgical aspects of ovarian endometriotic cysts. Arch. Gynecol. 233, 37–45 (1982). https://doi.org/10.1007/BF02110677 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/BF02110677

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endometriosisadenomyosis

MeSH descriptors

Endometriosis Ovarian Cysts Adolescent Adult Aged Endometriosis Endometriosis Female Humans Middle Aged Ovarian Cysts Ovarian Cysts Ovarian Cysts

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