Fatores preditores de recorrência do endometrioma ovariano após tratamento laparoscópico

Mariana de Sousa Ribeiro de Carvalho, Ana Maria Gomes Pereira, João Alfredo Martins, Reginaldo Coelho Guedes Lopes
Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2015 · vol. 37(2) , pp. 77–81 · doi:10.1590/so100-720320140005199 · PMID:25760626 · W1967463154
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Abstract

PURPOSE: To analyze the factors that might influence the recurrence of ovarian endometriomas after laparoscopic excision. METHODS: A retrospective cohort study. We evaluated 129 patients who underwent laparoscopic excision of ovarian endometriomas from 2003 to 2012 and who were followed up for at least two years after surgery. Vaginal ultrasound was repeated to exclude persistent lesion and to identify recurrence. The Student's t-test was used to compare continuous variables and the χ2 or Fischer exact test (for values of less than five) was used to test homogeneity between proportions. A logistic regression model for multivariate proportional hazards was used to analyze predictors of long-term outcome. The level of significance was set at 5% in all analyses. RESULTS: The overall rate of ovarian endometrioma recurrence was 18.6%. Endometrioma diameter, surgical procedure techniques and demographic data such as age, presenting symptoms, body mass index, smoking and physical exercise habits were not associated with recurrence, whereas interruption of postoperative medical treatment was significantly correlated with a higher recurrence rate (OR 23.7; 95%CI 5.26-107.05; p=0.001). CONCLUSION: Current oral contraceptive use appears to be associated with a dramatic reduction in the risk of recurrence of ovarian endometriotic cysts. Treatment interruption was associated with a higher recurrence rate of ovarian endometrioma after laparoscopic treatment.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Laparoscopy Ovarian Diseases Adult Cohort Studies Endometriosis Female Humans Ovarian Diseases Prognosis Recurrence Retrospective Studies

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