An insight into the associated factors with recurrent endometriomas after surgical excision

This correspondence comments on a previously published study (Atwa et al.) examining factors associated with recurrent endometriomas after surgical excision, highlighting that laparoscopic surgery may act as a confounder. The authors list associated factors for recurrence including incomplete excision, advanced disease stage, hormonal imbalance, endometriosis-related inflammation, genetic predisposition, surgical technique, and postoperative management. A key limitation they emphasize in the referenced study is that it included only patients undergoing laparoscopic excision, while open ovarian surgery patients were excluded, potentially biasing interpretation given laparoscopic impacts on ovarian reserve and outcomes and possible links to prior pelvic surgery via hypothesized inflammatory or anatomical mechanisms. This paper is centrally about endometriosis — it discusses recurrence of endometriomas after surgical excision and specifically addresses factors, including surgical approach, related to endometriosis-associated ovarian disease.

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