The pain symptoms and mass recurrence rates after ovarian cystectomy or uni/bilateral oophorectomy procedures in patients over 40 years old with endometriosis

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This study compared pain and mass recurrence rates after ovarian cystectomy versus uni/bilateral oophorectomy in women over 40 with endometriosis, finding no significant differences between the surgical approaches.

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This retrospective tertiary-center study evaluated pain symptoms and mass recurrence in 98 endometriosis patients over age 40 undergoing laparoscopic ovarian cystectomy, unilateral oophorectomy, or uni/bilateral salpingo-oophorectomy, with follow-up every 3 months using VAS pelvic pain scores and ultrasound. Across groups, age, BMI, cyst diameter, CA-125, pain scores, follow-up duration, and hospital stay were compared, and recurrence laterality, recurrence rates, and recurrence type did not significantly differ between surgical groups. The authors reported that gravidity and parity were higher in the bilateral salpingo-oophorectomy group than in other groups as a significant baseline difference. This paper is centrally about endometriosis — it specifically compares postoperative pelvic pain and ovarian mass recurrence after ovarian tissue–preserving versus oophorectomy procedures in women over 40 with endometriosis.

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Abstract

OBJECTIVES: To evaluate the rates of pain and mass recurrence of the patients over 40 years old with endometriosis who underwent ovarian cystectomy or uni/bilateral oophorectomy. MATERIAL AND METHODS: A retrospective study was conducted with 98 patients undergoing laparoscopic surgery for endometriosis in a tertiary referral center between the time period July 2015 and July 2019. All the patients followed every 3 months and requested to fill the Visual Analogue Scale (VAS) for evaluation of pelvic pain and an ultrasound scan was performed. The inclusion criteria for this study were as follows, patients with ages over 40, with regular menstrual periods, and who denied hysterectomy and any postoperative hormonal medical treatments. RESULTS: When the groups were compared in terms of age, body mass index, cyst diameter, CA-125 serum concentrations, preoperative and after surgical pelvic pain scores, mean follow up periods, postoperative hospital stay. However, each of the mean numbers of gravidity and parity were significantly higher than bilateral salpingo-oophorectomy (BSO) groups compared to the other groups (p = 0.04 and p = 0.03, respectively). The laterality, the recurrence rates, and the type of recurrence did not have a significant effect in the group comparison. CONCLUSIONS: The ovarian tissue preserving procedures could be offered for the women over 40 years old suffering from endometriosis with no significant increase in pain symptom or mass recurrence rates considering beneficial effects of estrogen on cardiovascular system, vasomotor symptoms, and bone mineral density.
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Abstract

Objectives: To evaluate the rates of pain and mass recurrence of the patients over 40 years old with endometriosis who underwent ovarian cystectomy or uni/bilateral oophorectomy. Material and methods: A retrospective study was conducted with 98 patients undergoing laparoscopic surgery for endometriosis in a tertiary referral center between the time period July 2015 and July 2019. All the patients followed every 3 months and requested to fill the Visual Analogue Scale (VAS) for evaluation of pelvic pain and an ultrasound scan was performed. The inclusion criteria for this study were as follows, patients with ages over 40, with regular menstrual periods, and who denied hysterectomy and any postoperative hormonal medical treatments. Results: When the groups were compared in terms of age, body mass index, cyst diameter, CA-125 serum concentrations, preoperative and after surgical pelvic pain scores, mean follow up periods, postoperative hospital stay. However, each of the mean numbers of gravidity and parity were significantly higher than bilateral salpingo-oophorectomy (BSO) groups compared to the other groups (p = 0.04 and p = 0.03, respectively). The laterality, the recurrence rates, and the type of recurrence did not have a significant effect in the group comparison. Conclusions: The ovarian tissue preserving procedures could be offered for the women over 40 years old suffering from endometriosis with no significant increase in pain symptom or mass recurrence rates considering beneficial effects of estrogen on cardiovascular system, vasomotor symptoms, and bone mineral density.

Keywords

endometriosispain symptomrecurrenceoophorectomy

References

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Outcome instruments

VAS-pain

Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Pelvic Pain Tissue Preservation Adult Endometriosis Endometriosis Endometriosis Female Humans Middle Aged Pelvic Pain Pelvic Pain Postoperative Complications Postoperative Complications Recurrence Retrospective Studies Tissue Preservation

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