OC174: Sonographic evaluation and follow up of endometriomas recurrence after laparoscopic removal

The aim of this study was to evaluate the role of transvaginal sonography (TVS) in the detection and follow-up of recurrence of ovarian endometriomas after laparoscopic removal. We studied 62 patients in fertile age who underwent laparoscopic removal by stripping of ovarian endometrioma and at TVS follow-up showed a recurrence. Recurrence of ovarian endometrioma was defined as the presence of cysts in the ovarian parenchyma with a typical sonographic aspect and a diameter of more than 10 mm. Postoperative follow-up period was from 3 to 48 months. Forty patients present a recurrence on the treated ovary, 12 had recurrence on the controlateral untreated ovary and 10 had bilateral recurrence. Recurrence was associated with pain or infertility in 46 patients (74%) and the remaining patients were asymptomatic. Thirty patients (48%) had a recurrent endometrioma with a maximum diameter > 30 mm. In only in one of these was surgery repeated due to pain and extent of adhesions. The others underwent medical therapy and follow-up. Twenty (32%) patients had an endometrioma > 30 5 cm, 10 repeated surgery and 2 had medical therapy. A total of 48 (77%) patients despite recurrence underwent follow-up associated with different medical treatment. Endometrioma size was reduced or unchanged in 86% of cases. Accurate postoperative TVS follow-up to be seems effective in the detection of recurrence of ovarian endometriomas and, associated to medical therapy, useful in preventing second surgery.