Peritoneal defects and the development of endometriosis in relation to the timing of endoscopic surgery during the menstrual cycle

Karl-Werner Schweppe, Dieter Ring, Ring D
Fertility and Sterility · 2002 · vol. 78(4) , pp. 763–766 · doi:10.1016/s0015-0282(02)03431-3 · PMID:12372453 · W2004556974
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This study investigates the correlation between the timing of endoscopic surgery during the menstrual cycle and the development of endometriosis via peritoneal defects.

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Abstract

ObjectiveIn vitro studies demonstrated that implantation on membranes (peritoneum, amniotic membranes) can take place if there are defects on the surface of the membranes. If these mechanisms play a role for the development of endometriosis in vivo, then patients with surgical treatment of peritoneal endometriosis in the luteal phase must have a high recurrence rate.DesignRetrospective analysis of operation charts and follow-up data.SettingDepartment of gynecology, in a hospital-based endometriosis treatment center.Patient(s)Two hundred twenty premenopausal women.Intervention(s)Laparoscopic treatment for peritoneal endometriosis, stage I and II by revised American Society for Reproductive Medicine guidelines.Main outcome measure(s)During the follow-up period of 2 years, symptoms and gynecological and sonographic findings were documented. In case of suspected recurrence a repeat laparoscopy with biopsy was performed to prove the recurrent endometriosis macroscopically and histologically.Result(s)The total recurrence rate after 2 years was 9.6%. The recurrence rate of group III (15%) was twice as high as those of group I (7%) and group II (8%), as indicated by subjective complaints, clinical findings, macroscopy, and histology; no differences were found between groups I and II.Conclusion(s)Endoscopic surgery for the treatment of peritoneal endometriosis should not be performed in the luteal phase.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Laparoscopy Menstrual Cycle Peritoneal Diseases Biopsy Endometriosis Endometriosis Female Follicular Phase Humans Luteal Phase Ovulation Peritoneal Diseases Peritoneal Diseases Premenopause Recurrence Reoperation Retrospective Studies Time Factors Treatment Outcome

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