Management of endometriomas
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Abstract
Ovarian endometriomas could affect up to 44% of women with endometriosis, and are often associated with pelvic pain and infertility. Treatment options include expectant management, medical and/or surgical treatment, and in vitro fertilization. The choice of treatment depends mostly on the associated symptoms. In most cases, surgery is the preferred choice, since endometriomas do not respond to medical treatment, which may only treat associated pain. In case of infertility, in vitro fertilization and embryo transfer may be a suitable alternative to surgery, particularly when there is no associated pain. According to the best available scientific evidence, laparoscopic excision of the endometrioma wall should be considered the procedure of choice. The surgical excision may damage the ovarian reserve. At the same time, recent evidences demonstrate that part of the damage may be due to the presence of the endometrioma itself. Indication to surgical treatment should balance the possible risks of damaging the ovarian reserve with the advantages of surgery in terms of satisfactory pain relief rates and pregnancy rates, and of obtaining tissue specimen for ruling out the rare cases of unexpected ovarian malignancy. A score system to guide the clinician in the decision to perform or withhold surgery and endometriosis fertility index are presented.
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Cited by (20)
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- Prevention of endometriosis recurrence after surgical treatment 2023
- Expectant, Medical, and Surgical Management of Ovarian Endometriomas 2023
- Treatment of endometriomas: Surgical approaches and the impact on ovarian reserve, recurrence, and spontaneous pregnancy 2023
- Use of Oxidized Regenerated Cellulose (ORC) in treatment of ovarian endometriomas to prevent recurrence and preserve ovarian reserve 2023
- Risk factors for recurrent endometriosis after conservative surgery in a quaternary care center in southern Thailand 2023
- Evaluación clínica y manejo de la endometriosis: resumen de la Orientación Técnica MINSAL para el manejo de personas con endometriosis 2023
- Biomarkers of endometriosis 2023
- Optimal Tactics of Infertility Treatment in Women with Ovarian Endometriomas 2021
- Surgical management of endometriosis-associated pain 2021
- The patient with an endometrioma 2021
- Laparoscopic Ethanol Sclerotherapy for Ovarian Endometriomas: Preliminary Results 2020
- Endométriome et prise en charge en FIV, RPC Endométriose CNGOF-HAS 2018
- Antimüllerian hormone is reduced in the presence of ovarian endometriomas: a systematic review and meta-analysis 2018
- Perimenopausal management of ovarian endometriosis and associated cancer risk: When is medical or surgical treatment indicated? 2018
- Isolated Ovarian Endometrioma: A History Between Myth and Reality 2018
- A stepped-care approach to symptomatic endometriosis management: a participatory research initiative 2018
- Evidence-Based Medicine: Pandora's Box of Medical and Surgical Treatment of Endometriosis 2017
- Recurrent Endometrioma; Outcome of Medical Management with Dienogest 2017
- Management of Endometriosis: Toward Value-Based, Cost-Effective, Affordable Care 2017
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- last seen: 2026-06-04T00:00:01.174412+00:00
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