Ovarian damage due to cyst removal: a comparison of endometriomas and dermoid cysts

Signe Perlman, Jens Jørgen Kjer
Acta obstetricia et gynecologica Scandinavica · 2015 · vol. 95(3) , pp. 285–290 · doi:10.1111/aogs.12841 · PMID:26669273 · W2210417153
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Laparoscopic cystectomy for ovarian endometriomas resulted in unintended removal of ovarian tissue in 80.3% of cases, significantly higher than the 17.2% observed for dermoid cysts.

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Abstract

INTRODUCTION: Surgical treatment of endometriomas and potential damage to the ovary have been debated. Studies have described the inconsistent risk of unintended removal of ovarian tissue when a cystectomy of an endometrioma is performed. We evaluated the risk of inadvertently removed ovarian tissue during surgery by comparing specimens of endometriomas and dermoid cysts removed laparoscopically. MATERIAL AND METHODS: The material included 326 women in a retrospective cohort study at Rigshospitalet, University hospital in Copenhagen, Denmark from 2011 to 2013. Surgery was performed laparoscopically for 393 benign cysts with a diagnosis of either endometrioma (n = 294) or dermoid cyst (n = 99). The microscopic existence of ovarian tissue in the cystectomy specimens were compared and correlation between CA 125 and size of cysts was examined. RESULTS: In total, 80.3% endometrioma cystectomies disclosed ovarian stroma compared with 17.2% of the resected dermoid cysts (p < 0.001). The difference was found despite skilled laparoscopic surgeons performing the procedure in the endometriosis cohort. A significant positive correlation between the size of endometriomas and the value of CA 125 was found (p < 0.009). CONCLUSION: The risk of removal of ovarian tissue during laparoscopic surgery is significantly higher for endometriomas than for dermoid cysts.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Dermoid Cyst Dermoid Cyst Endometriosis Endometriosis Ovarian Neoplasms Ovarian Neoplasms Ovary Adolescent Adult CA-125 Antigen CA-125 Antigen Dermoid Cyst Dermoid Cyst Endometriosis Endometriosis Female Humans Laparoscopy Laparoscopy Middle Aged

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