Risk factors for recurrence and re-recurrence of ovarian endometriomas after laparoscopic excision

Shinichi Hayasaka, Hayasaka S, Ugajin T, Tomohisa Ugajin, Fujii O, Osamu Fujii, Nabeshima H, Hiroshi Nabeshima, Utsunomiya H, Hiroki Utsunomiya, Yokomizo R, Rei Yokomizo, Hiromithu Yuki, Yuki H, Yukihiro Terada, Terada Y, Takashi Murakami, Murakami T, Yaegashi N, Nobuo Yaegashi
Journal of Obstetrics and Gynaecology Research · 2010 · vol. 37(6) , pp. 581–585 · doi:10.1111/j.1447-0756.2010.01409.x · PMID:21159045 · W1532414967
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This study identified high revised American Society for Reproductive Medicine scores as a risk factor for ovarian endometrioma recurrence and postoperative pregnancy as protective, while short menstrual periods without pregnancy or GnRH analogue treatment increased re-recurrence risk.

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Abstract

AIM: Since ovarian endometrioma is frequently diagnosed in women of reproductive age, laparoscopic excision of the endometrioma is performed for most cases. However, endometriomas frequently recurs even after repeated surgical procedures. The aim of our study is to identify risk factors for recurrence and re-recurrence of endometriomas after the first and second laparoscopic excision. MATERIAL & METHODS: We retrospectively evaluated 173 patients who had a minimum of one year postoperative follow-up after the laparoscopic excision of endometriomas. Ten and eight factors were evaluated to assess their effect on the risk of recurrence and re-recurrence, respectively. Factors were analyzed using univariate and the Cox regression test. RESULTS: The overall rate of recurrence and re-recurrence were 45.1% and 45.5%, respectively. A high revised American Society for Reproductive Medicine score (1997) was associated with an increased risk of recurrence. Only postoperative pregnancy was associated with a decreased risk of recurrence. Short periods of normal menstruation without pregnancy or gonadotrophin-releasing hormone analogues from first surgery to recurrence were associated with higher rate of re-recurrence. CONCLUSIONS: A high revised American Society for Reproductive Medicine score was a risk factor, and postoperative pregnancy was protective against recurrence. The patient with short periods of normal menstruation without pregnancy or gonadotrophin-releasing hormone analogues from first surgery to recurrence had a high risk of re-recurrence.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Endometriosis Ovarian Diseases Ovarian Diseases Adult Adult Endometriosis Endometriosis Female Female Follow-Up Studies Follow-Up Studies Humans Humans Japan Japan Japan Laparoscopy Laparoscopy Ovarian Diseases

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