Recurrence of endometriosis

In: Endometriosis · 2020 · pp. 139–147 · doi:10.1201/9780429448980-17 · W3010622160
book-chapter OA: closed CC0 ⤵ 8 in-corpus citations
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Recurrent endometriosis, challenging to manage, arises from residual, microscopic, or de novo lesions, influenced by factors like young age and advanced disease, with no validated biomarkers found thus far.

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Abstract

Recurrent endometriosis is a challenging task for the gynecologist. Recurrence occurs due to regrowth of residual endometriotic cells or growth of microscopic endometriotic lesions, which remain undetected at time of surgery, or due to development of de novo/fresh lesions, or a combination thereof. Various risk factors for recurrence have been studied, which include young age, advanced stage of disease, bilaterality of lesions, incomplete previous surgery, high revised American Fertility Society score, and deep endometriosis, etc. Various biomarkers have been studied such as glycoproteins, hormones, micro-RNAs, and cytokines, but none has been validated independently as a biomarker for endometriosis. CA-125 has been extensively studied as a biomarker but is nonspecific. Management of recurrent endometriosis varies with symptomatology as well previous history. As far as fertility is concerned, second surgery is even more detrimental. Artificial reproductive techniques should be the management of choice. Medical management in the form of combined oral contraceptives, progesterone, dienogest, or GnRH analogues can be used.

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endometriosis

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