Prevention of Recurrence After Surgery

Recurrence of ovarian endometrioma after excision imposes profound encumbrance on the suffered women, with increasing pain, subfertility/infertility, and a risk of ovarian cancer. Postoperative recurrence is relatively common, the rate ranging from 11 to 32 % in 1–5 years. To date, a number of risk factors for the recurrence have been reported, i.e., younger age, larger cysts, high rASRM scores, previous medical treatment, previous surgery for endometriosis, and short-term postoperative medical treatment. In contrast, postoperative pregnancy reduces the risk. Several biomarkers are suggested to predict the recurrence but not yet validated in clinical practice. Postoperative OC use for a long period has been demonstrated to reduce the recurrence remarkably. Postoperative GnRH analogue use is also effective for the reduction of the recurrence. There still remain some issues on the duration and the drugs most suitable for the prevention. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Wheeler JM, Malinak LR. Recurrent endometriosis: incidence, management, and prognosis. Am J Obstet Gynecol. 1983;146(3):247–53. Busacca M, Chiaffarino F, Candiani M, Vignali M, Bertulessi C, Oggioni G, Parazzini F. Determinants of long-term clinically detected recurrence rates of deep, ovarian, and pelvic endometriosis. Am J Obstet Gynecol. 2006;195(2):426–32. Busacca M, Marana R, Caruana P, Candiani M, Muzii L, Calia C, Bianchi S. Recurrence of ovarian endometrioma after laparoscopic excision. Am J Obstet Gynecol. 1999;180(3):519–23. Ghezzi F, Beretta P, Franchi M, Parissis M, Bolis P. Recurrence of ovarian endometriosis and anatomical location of the primary lesion. Fertil Steril. 2001;75(1):136–40. Alborzi S, Momtahan M, Parsanezhad ME, Dehbashi S, Zolghadri J, Alborzi S. A prospective, randomized study comparing laparoscopic ovarian cystectomy versus fenestration and coagulation in patients with endometriomas. Fertil Steril. 2004;82(6):1633–7. Kikuchi I, Takeuchi H, Kitade M, Shimanuki H, Kumakiri J, Kinoshita K. Recurrence rate of endometriomas following a laparoscopic cystectomy. Acta Obstet Gynecol Scand. 2006;85(9):1120–4. Parazzini F, Bertulessi C, Pasini A, Rosati M, Di Stefano F, Shonauer S, Vicino M, Aguzzoli L, Trossarelli GF, Massobrio M, Bracco G, Perino A, Moroni S, Beretta P. Determinants of short term recurrence rate of endometriosis. Eur J Obstet Gynecol Reprod Biol. 2005;121(2):216–9. Koga K, Takemura Y, Osuga Y, Yoshino O, Hirota Y, Hirata T, Morimoto C, Harada M, Yano T, Taketani Y. Recurrence of ovarian endometrioma after laparoscopic excision. Hum Reprod. 2006;21(8):2171–4. Vercellini P, Fedele L, Aimi G, De Giorgi O, Consonni D, Crosignani PG. Reproductive performance, pain recurrence and disease relapse after conservative surgical treatment for endometriosis: the predictive value of the current classification system. Hum Reprod. 2006;21(10):2679–85. Liu X, Yuan L, Shen F, Zhu Z, Jiang H, Guo SW. Patterns of and risk factors for recurrence in women with ovarian endometriomas. Obstet Gynecol. 2007;109(6):1411–20. Vercellini P, Somigliana E, Daguati R, Vigano P, Meroni F, Crosignani PG. Postoperative oral contraceptive exposure and risk of endometrioma recurrence. Am J Obstet Gynecol. 2008;198(5):504.e1–5. Evers JL, Dunselman GA, Land JA, Bouckaert PX. Is there a solution for recurrent endometriosis? Br J Clin Pract Suppl. 1991;72:45–50. discussion 51-43. Exacoustos C, Zupi E, Amadio A, Amoroso C, Szabolcs B, Romanini ME, Arduini D. Recurrence of endometriomas after laparoscopic removal: sonographic and clinical follow-up and indication for second surgery. J Minim Invasive Gynecol. 2006;13(4):281–8. doi:10.1016/j.jmig.2006.03.002. Blumenfeld Z. Hormonal suppressive therapy for endometriosis may not improve patient health. Fertil Steril. 2004;81(3):487–92. Vercellini P, Somigliana E, Vigano P, Abbiati A, Barbara G, Fedele L. ‘Blood On The Tracks’ from corpora lutea to endometriomas. BJOG. 2009;116(3):366–71. Busacca M, Bianchi S, Agnoli B, Candiani M, Calia C, De Marinis S, Vignali M. Follow-up of laparoscopic treatment of stage III-IV endometriosis. J Am Assoc Gynecol Laparosc. 1999;6(1):55–8. Porpora MG, Pallante D, Ferro A, Crisafi B, Bellati F, Benedetti Panici P. Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study. Fertil Steril. 2010;93(3):716–21. Shen F, Liu X, Geng JG, Guo SW. Increased immunoreactivity to SLIT/ROBO1 in ovarian endometriomas: a likely constituent biomarker for recurrence. Am J Pathol. 2009;175(2):479–88. Shen F, Wang Y, Lu Y, Yuan L, Liu X, Guo S-W. Immunoreactivity of progesterone receptor isoform B and nuclear factor kappa-B as biomarkers for recurrence of ovarian endometriomas. Am J Obstet Gynecol. 2008;199(5):486.e1–486.e10. Yuan L, Shen F, Lu Y, Liu X, Guo S-W. Cyclooxygenase-2 overexpression in ovarian endometriomas is associated with higher risk of recurrence. Fertil Steril. 2009;91(4, Suppl):1303–6. Takamura M, Koga K, Osuga Y, Takemura Y, Hamasaki K, Hirota Y, Yoshino O, Taketani Y. Post-operative oral contraceptive use reduces the risk of ovarian endometrioma recurrence after laparoscopic excision. Hum Reprod. 2009;24(12):3042–8. Muzii L, Marana R, Caruana P, Catalano GF, Margutti F, Panici PB. Postoperative administration of monophasic combined oral contraceptives after laparoscopic treatment of ovarian endometriomas: A prospective, randomized trial. Am J Obstet Gynecol. 2000;183(3):588–92. Seracchioli R, Mabrouk M, Frascà C, Manuzzi L, Montanari G, Keramyda A, Venturoli S. Long-term cyclic and continuous oral contraceptive therapy and endometrioma recurrence: a randomized controlled trial. Fertil Steril. 2010;93(1):52–6. Jee BC, Lee JY, Suh CS, Kim SH, Choi YM, Moon SY. Impact of GnRH agonist treatment on recurrence of ovarian endometriomas after conservative laparoscopic surgery. Fertil Steril. 2009;91(1):40–5. Lee D-Y, Bae D-S, Yoon B-K, Choi D. Post-operative cyclic oral contraceptive use after gonadotrophin-releasing hormone agonist treatment effectively prevents endometrioma recurrence. Hum Reprod. 2010;25(12):3050–4. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2014 Springer Japan About this chapter Cite this chapter Osuga, Y., Takemura, Y., Takamura, M., Koga, K. (2014). Prevention of Recurrence After Surgery. In: Harada, T. (eds) Endometriosis. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54421-0_25 Download citation DOI: https://doi.org/10.1007/978-4-431-54421-0_25 Published: Publisher Name: Springer, Tokyo Print ISBN: 978-4-431-54420-3 Online ISBN: 978-4-431-54421-0 eBook Packages: MedicineMedicine (R0)