Multifaceted analysis in the surgery of the endometriotic cyst and the significance of the resection of the median pelvic endometriosis

Kiyohiko Yamada, Masayuki Soda, Hideaki Itoh, Tomomi Murata, Chiaki Banzai, Chika Nishizawa, Natsuyuki Fujisawa
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2024 · vol. 40(1) , pp. 69–79 · doi:10.5180/jsgoe.40.1_69 · W4402030288
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study performed a multifaceted analysis of endometriotic cyst surgery, investigating the significance of resecting median pelvic endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This retrospective observational study analyzed outcomes of laparoscopic surgery for endometriotic cysts in 885 patients treated at a regional medical support hospital in Japan from 2005 to 2016, with 420 undergoing resection of median pelvic endometriosis (RME). Pain was evaluated using a 10-cm visual analogue scale for menstrual pain and chronic pelvic pain, alongside assessments of pain recurrence and cyst recurrence, as well as premature menopause, pregnancy outcomes, perinatal complications, ovarian cancer, and other organ complications. The authors found that endometriotic cyst resection improved postoperative menstrual pain and chronic pelvic pain, and that pain relief was more effective when RME was performed; however, postoperative pain recurrence was not related to RME and was significantly suppressed by hormone therapy. The paper does not explicitly state limitations such as potential selection bias for receiving RME, which is relevant given its retrospective design. This paper is centrally about endometriosis — it evaluates laparoscopic surgery for endometriotic cysts and specifically tests the significance of median pelvic endometriosis resection (RME) for postoperative pain outcomes.

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Abstract

Objective: To consider of the surgery of the endometriotic cyst multifacedly, and to investigate the significance of performing resection of the median pelvic endometriosis (RME).
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Objective

To consider of the surgery of the endometriotic cyst multifacedly, and to investigate the significance of performing resection of the median pelvic endometriosis (RME). Design: Retrospective observational study. Setting: Regional medical support hospital Patients: A total of 885 patients who underwent laparoscopic surgery for the endometriotic cysts from 2005 to 2016 at Japanese Red Cross Maebashi Hospital were included. Intervention: Under the diagnosis of endometriotic cyst based on physical findings, ultrasonography, MRI, etc., the cyst was operated by laparoscopic surgery, along with uterine fibroid enucleation or hysterectomy/supracervical hysterectomy, depending on the case. Of those, 420 underwent RME. Main Outcomes: Pain symptoms were assessed with a 10 cm visual analogue scale (VAS), and the status of pain relief and recurrence after surgery were investigated. Additionally, recurrence of cysts, occurrence of premature menopause, pregnancy, delivery, perinatal complications, ovarian cancer, complications of other organ diseases were investigated.

Results

Resection of endometriotic cysts was effective in improving postoperative menstrual pain and chronic pelvic pain. Pain symptoms were relieved more effectively by performing RME. Postoperative pain recurrence was not related to the RME, and hormone therapy significantly suppressed pain recurrence. Recurrence of ovarian cysts was found in 4.6％. Premature menopause before 40 years of age occurred in 1.53％. Thirty-one ％ of those who wished to have children had at least one pregnancy. Eight patients (0.94％) were found to have ovarian cancer, 7 patients survived on disease free, of those three patients became pregnant and delivered after surgery.

Conclusions

In surgery for endometriotic cysts, combined RME improved pain more effectively. © 2024 日本産科婦人科内視鏡学会

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Outcome instruments

VAS-pain

Condition tags

endometriosis

Citation neighborhood

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References (40)

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