Recommendations for the Surgical Treatment of Endometriosis. Part 1: Ovarian Endometrioma†‡¶
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This document provides ESGE, ESHRE, and WES recommendations on surgical techniques for ovarian endometrioma treatment in reproductive-aged women.
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Abstract
Abstract STUDY QUESTION What does this document on the surgical treatment of endometriosis jointly prepared by the European Society for Gynaecological Endoscopy (ESGE), ESHRE, and the World Endometriosis Society (WES) provide? SUMMARY ANSWER This document provides recommendations covering technical aspects of different methods of surgery for endometriomas in women of reproductive age. WHAT IS ALREADY KNOWN Endometriomas (ovarian endometriotic cysts) are a commonly diagnosed form of endometriosis, owing to the relative ease and accuracy of ultrasound diagnosis. They frequently present a clinical dilemma as to whether and how to treat them when found during imaging or incidentally during surgery. Previously published guidelines have provided recommendations based on the best available evidence, but without technical details on the management of endometriosis. STUDY DESIGN SIZE, DURATION A working group of ESGE, ESHRE and WES collaborated on writing recommendations on the practical aspects of endometrioma surgery. PARTICIPANTS/MATERIALS, SETTING, METHODS This document focused on endometrioma surgery. Further documents in this series will provide recommendations for surgery of deep and peritoneal endometriosis. MAIN RESULTS AND THE ROLE OF CHANCE The document presents general recommendations for surgery of endometrioma, and specific recommendations for cystectomy, ablation by laser or by plasma energy, electrocoagulation and a combination of these techniques applied together or with an interval between them. LIMITATIONS REASONS FOR CAUTION Owing to the limited evidence available, recommendations are mostly based on clinical expertise. WIDER IMPLICATIONS OF THE FINDINGS These recommendations complement previous guidelines on the management of endometriosis. STUDY FUNDING/COMPETING INTERESTS The meetings of the working group were funded by ESGE, ESHRE and WES. C.B. declares to be a member of the independent data monitoring committee for a clinical study by ObsEva, and receiving research grants from Bayer, Roche Diagnostics, MDNA Life Sciences, and Volition. E.S. received honoraria for provision of training to healthcare professionals from Ethicon, Olympus and Gedeon Richter. The other authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER NA.
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- Analysis of cumulative live birth rate outcomes of three ovarian stimulation protocols in patients after laparoscopic cystectomy of ovarial endometrioma: a retrospective cohort study 2023
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- Ethanol Sclerotherapy versus Laparoscopic Surgery in Management of Ovarian Endometrioma; a Randomized Clinical Trial 2022
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- An Unusual Case of a Large Extraovarian Endometrioma in an Adolescent 2022
- DEEP ENDOMETRIOSIS: OVERWIEW OF CURRENT RECOMMENDATIONS AND OWN DATA 2022
- Structured report for dynamic ultrasonography in patients with suspected or known endometriosis: Recommendations of the International Society for Gynecologic Endoscopy (ISGE) 2021
- Laparoskopie bei Infertilität, Tubenpathologie, Endometriose und vor ART 2021
- Managing endometrioma to optimize future fertility 2021
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- Endometrioma surgery–a systematic review and meta-analysis of the effect on antral follicle count and anti-Müllerian hormone 2021
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- The role of the macrophage polarization type in the pathogenesis of endometrioid disease 2021
- Excision of endometriosis – optimising surgical techniques 2021
- RETRACTED: The effect of vasopressin injection on ovarian reserve in patients with ovarian endometrioma: a randomized controlled trial 2021
- The Significance of Planned Fertility Preservation for Women With Endometrioma Before an Expected Ovarian Cystectomy 2021
- Fertility sparing endometriosis surgery: A review 2021
- Obstetrical complications and outcome in patients with endometriosis 2020
- STANDARDIZATION OF LAPAROSCOPIC TREATMENT PATIENTS WITH DEEP INFILTRATIVE ENDOMETRIOSIS 2020
- Circulating CD56+ NKG2D+ NK cells and postoperative fertility in ovarian endometrioma 2020
- A European survey on the conservative surgical management of endometriotic cysts on behalf of the European Society for Gynaecological Endoscopy (ESGE) Special Interest Group (SIG) on Endometriosis. 2020
- Sonographic Assessment of Ovarian Endometrioma Recurrence Six Months After Laparoscopic Cystectomy in Patients with Endometriosis 2019
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