Recurrence of ovarian endometrioma after laparoscopic excision

Kaori Koga, K Koga, Yuri Takemura, Y Takemura, Y Osuga, Yutaka Osuga, Osamu Yoshino, O Yoshino, Y Hirota, Yasushi Hirota, T Hirata, Tetsuya Hirata, Chieko Morimoto, C Morimoto, Miyuki Harada, M Harada, Tomone Yano, T Yano, Y Taketani
Human Reproduction · 2006 · vol. 21(8) , pp. 2171–2174 · doi:10.1093/humrep/del125 · PMID:16644912 · W2133530351
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Previous medical treatment for endometriosis and larger cyst size independently predicted higher recurrence rates after laparoscopic excision, while post-operative pregnancy was associated with lower recurrence.

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Abstract

BACKGROUND: To analyse risk factors that influence the recurrence of endometrioma after laparoscopic excision. METHODS: A total of 224 patients who had a minimum of 2 years of post-operative follow-up after laparoscopic ovarian endometrioma excision were studied retrospectively. Recurrence was defined as the presence of endometrioma more than 2 cm in size, detected by ultrasonography within 2 years of surgery. Fourteen variables (age, presence of infertility, pain, uterine myoma, adenomyosis, previous medical treatment of endometriosis, previous surgery for ovarian endometriosis, single or multiple cysts, the size of the largest cyst at laparoscopy, unilateral or bilateral involvement, co-existence of deep endometriosis, revised American Society for Reproductive Medicine (ASRM) score, post-operative medical treatment and post-operative pregnancy) were evaluated to assess their independent effects on the recurrence using logistic regression analysis. RESULTS: The overall rate of recurrence was 30.4% (68/224). Significant factors that were independently associated with higher recurrence were previous medical treatment of endometriosis [odds ratio (OR) = 2.324, 95% confidence interval (95% CI) = 1.232-4.383, P = 0.0092) and larger diameter of the largest cyst (OR = 1.182, 95% CI = 1.004-1.391, P = 0.0442). Post-operative pregnancy was associated with lower recurrence (OR = 0.292, 95% CI = 0.028-0.317, P = 0.0181). CONCLUSIONS: Previous medical treatment of endometriosis or large cyst size was a significant factor that was associated with higher recurrence of the disease. Post-operative pregnancy is a favourable prognostic factor.

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Condition tags

endometriosisadenomyosisendometriomainfertility

MeSH descriptors

Endometriosis Endometriosis Ovarian Diseases Ovarian Diseases Adult Danazol Danazol Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Laparoscopy Ovarian Diseases Ovarian Diseases Pregnancy Prognosis Recurrence Retrospective Studies

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