Pain and Fertility Outcomes in Patients Undergoing Cyst Excision Versus Cyst Aspiration in Moderate to Severe Endometriosis: A Case Series

Background: Endometriosis and ovarian cysts are prevalent gynecological disorders characterized by the presence of abnormal tissue growth in the pelvic cavity. Objective: To document the pain and fertility outcomes in patients undergoing cyst excision versus cyst aspiration in moderate to severe endometriosis presenting to a tertiary healthcare facility. Methods: This was a case series conducted in the Department of Obstetrics and Gynecology, Vinayaka Missions Medical College & Hospital, Vinayaka Missions Research Foundation (VMRF, Deemed to be University), Karaikal, Puducherry, India between June 2021 and May 2023 (n=14). Results: The study included 14 patients, divided evenly with 7 undergoing cyst excision and 7 undergoing cyst aspiration. Before surgery, both groups had comparable baseline characteristics in terms of age, symptom severity, and the nature of the ovarian cysts. After surgery, patients who underwent cyst excision showed a higher rate of pain relief compared to those who underwent cyst aspiration (61% versus 26%, respectively). In terms of fertility outcomes, 55% of patients in the cyst excision group achieved improved clinical pregnancy outcomes after surgery, whereas 35% of those in the cyst aspiration group had comparable results. Conclusion: Cyst excision appears to be associated with superior pain relief and faster recovery compared to cyst aspiration in patients with endometriosis or ovarian cysts.