Recurrent Endometriosis

Endometriosis is considered a chronic condition with a high risk of recurrence following treatment; hence clinicians should be familiar with assessment of these patients. High recurrence rates of 20% after 2 years and up to 50% after 5 years have been reported. Up to one in four after minor surgery and one in five after major conservative surgery with ovarian preservation require additional endometriosis surgery within 5 years following operation. Recurrence appears to be less common after hysterectomy. Recurrence may be due to incomplete treatment or regrowth of the condition; however persistent or recurrent symptoms after surgery have usually a more complex background. Possibilities that the symptoms may not be due to endometriosis, centralisation of pain due to prolonged exposure and side effects of previous surgery/surgeries should be considered. A multidisciplinary approach that would be able to offer surgery, medical treatment and pain management would be necessary for the management of woman with recurrent endometriosis. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Ceccaroni M, Bounous VE, Clarizia R, Mautone D, Mabrouk M. Recurrent endometriosis: a battle against an unknown enemy. Eur J Contracept Reprod Health Care. 2019;24(6):464–74. https://doi.org/10.1080/13625187.2019.1662391. Epub 2019 Sep 25. Guo SW. Recurrence of endometriosis and its control. Hum Reprod Update. 2009;15(4):441–61. https://doi.org/10.1093/humupd/dmp007. Epub 2009 Mar 11. Bougie O, McClintock C, Pudwell J, Brogly SB, Velez MP. Long term follow-up of endometriosis surgery in Ontario: a population-based Cohort Study. Am J Obstet Gynecol. 2021;S0002-9378(21):00467-1. https://doi.org/10.1016/j.ajog.2021.04.237. Epub ahead of print. Busacca M, Chiaffarino F, Candiani M, et al. Determinants of long-term clinically detected recurrence rates of deep, ovarian, and pelvic endometriosis. Am J Obstet Gynecol. 2006;195:426–32. Chen FP, Soong YK, Lee N, et al. The use of serum CA-125 as a marker for endometriosis in patients with dysmenorrhea for monitoring therapy and for recurrence of endometriosis. Acta Obstet Gynecol Scand. 1998;77:665–70. Wykes CB, Clark TJ, Khan KS. Accuracy of laparoscopy in the diagnosis of endometriosis: a systematic quantitative review. BJOG. 2004;111:1204–12. Sutton CJ, Ewen SP, Whitelaw N, Haines P. Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal, mild, and moderate endometriosis. Fertil Steril. 1994;62:696–700. Nirgianakis K, Ma L, McKinnon B, Mueller MD. Recurrence patterns after surgery in patients with different endometriosis subtypes: a long-term Hospital-Based Cohort Study. J Clin Med. 2020;9(2):496. https://doi.org/10.3390/jcm9020496. PMID: 32054117; PMCID: PMC7073694. Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H. Surgical outcomes after colorectal surgery for endometriosis: a systematic review and meta-analysis. J Minim Invasive Gynecol. 2021;28(3):453–66. https://doi.org/10.1016/j.jmig.2020.08.015. Epub 2020 Aug 22. Abou-Setta AM, Houston B, Al-Inany HG, Farquhar C. Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery. Cochrane Database Syst Rev. 2013;(1):CD005072. https://doi.org/10.1002/14651858.CD005072.pub3. Seracchioli R, Mabrouk M, Manuzzi L, Vicenzi C, Frascà C, Elmakky A, Venturoli S. Post-operative use of oral contraceptive pills for prevention of anatomical relapse or symptom-recurrence after conservative surgery for endometriosis. Hum Reprod. 2009;24:2729–35. Zakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A. Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Hum Reprod Update. 2021;27(1):96–107. https://doi.org/10.1093/humupd/dmaa033. PMID: 33020832; PMCID: PMC7781224. Vercellini P, Somigliana E, Viganò P, De Matteis S, Barbara G, Fedele L. Post-operative endometriosis recurrence: a plea for prevention based on pathogenetic, epidemiological and clinical evidence. Reprod Biomed Online. 2010;21:259–65. Wattanayingcharoenchai R, Rattanasiri S, Charakorn C, Attia J, Thakkinstian A. Postoperative hormonal treatment for prevention of endometrioma recurrence after ovarian cystectomy: a systematic review and network meta-analysis. BJOG. 2021;128(1):25–35. https://doi.org/10.1111/1471-0528.16366. Epub 2020 Jul 14. PMID: 32558987; PMCID: PMC7754428. Saridogan E. Postoperative medical therapies for the prevention of endometrioma recurrence – do we now have the final answer? BJOG. 2021;128(1):36. https://doi.org/10.1111/1471-0528.16415. Epub 2020 Aug 10. Hart RJ, Hickey M, Maouris P, Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev. 2008;2:CD004992. https://doi.org/10.1002/14651858.CD004992.pub3. Working group of ESGE, ESHRE and WES, Keckstein J, Becker CM, Canis M, Feki A, Grimbizis GF, Hummelshoj L, Nisolle M, Roman H, Saridogan E, Tanos V, Tomassetti C, Ulrich UA, Vermeulen N, De Wilde RL. Recommendations for the surgical treatment of endometriosis Part 2: deep endometriosis †‡¶. Facts Views Vis Obgyn. 2020;11(4):269–97. PMID: 32322824; PMCID: PMC7162667. Namnoum AB, Hickman TN, Goodman SB, Gehlbach DL, Rock JA. Incidence of symptom recurrence after hysterectomy for endometriosis. Fertil Steril. 1995;64(5):898–902. https://doi.org/10.1016/s0015-0282(16)57899-6. Parker WH, Broder MS, Liu Z, Shoupe D, Farquhar C, Berek JS. Ovarian conservation at the time of hysterectomy for benign disease. Clin Obstet Gynecol. 2007;50(2):354–61. https://doi.org/10.1097/GRF.0b013e31804a838d. Abdou AM, Ammar IMM, Alnemr AAA, Abdelrhman AA. Dienogest versus leuprolide acetate for recurrent pelvic pain following laparoscopic treatment of endometriosis. J Obstet Gynaecol India. 2018;68(4):306–13. https://doi.org/10.1007/s13224-018-1119-3. Razzi S, Luisi S, Ferretti C, Calonaci F, Gabbanini M, Mazzini M, Petraglia F. Use of a progestogen only preparation containing desogestrel in the treatment of recurrent pelvic pain after conservative surgery for endometriosis. Eur J Obstet Gynecol Reprod Biol. 2007;135(2):188–90. https://doi.org/10.1016/j.ejogrb.2006.08.002. Vercellini P, De Giorgi O, Mosconi P, Stellato G, Vicentini S, Crosignani PG. Cyproterone acetate versus a continuous monophasic oral contraceptive in the treatment of recurrent pelvic pain after conservative surgery for symptomatic endometriosis. Fertil Steril. 2002;77(1):52–61. https://doi.org/10.1016/s0015-0282(01)02951-x. Koshiba A, Mori T, Okimura H, Akiyama K, Kataoka H, Takaoka O, Ito F, Matsushima H, Kusuki I, Kitawaki J. Dienogest therapy during the early stages of recurrence of endometrioma might be an alternative therapeutic option to avoid repeat surgeries. J Obstet Gynaecol Res. 2018;44(10):1970–6. https://doi.org/10.1111/jog.13725. Lee JH, Song JY, Yi KW, Lee SR, Lee DY, Shin JH, Cho S, Seo SK, Kim SH. Effectiveness of dienogest for treatment of recurrent endometriosis: multicenter data. Reprod Sci. 2018;25(10):1515–22. https://doi.org/10.1177/1933719118779733. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Sarıdoğan, E., Mueller, M.D. (2022). Recurrent Endometriosis. In: Oral, E. (eds) Endometriosis and Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_19 Download citation DOI: https://doi.org/10.1007/978-3-030-97236-3_19 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-97235-6 Online ISBN: 978-3-030-97236-3 eBook Packages: MedicineMedicine (R0)