Recurrence of ovarian endometrioma after laparoscopic excision

Busacca M, Mauro Busacca, M Busacca, R Marana, Marana R, Riccardo Marana, P Caruana, Paul Caruana, Caruana P, M. Candiani, Massimo Candiani, Ludovico Muzii, L Muzii, C. Calia, Calia C, Stefano Bianchi, S Bianchi
American journal of obstetrics and gynecology · 1999 · vol. 180(3) , pp. 519–523 · doi:10.1016/s0002-9378(99)70247-4 · PMID:10076121 · W2074796888
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This study investigated the recurrence rate of ovarian endometriomas following laparoscopic excision, analyzing factors that may influence recurrence.

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Abstract

ObjectiveOur purpose was to evaluate the recurrence rate after laparoscopic excision of ovarian endometrioma.Study designAn unrandomized prospective clinical study was performed at 2 tertiary-care centers of 366 patients who had a minimum of 6 months of postoperative follow-up or 6 months after the suspension of medical therapy after laparoscopic ovarian endometrioma excision. Patients underwent clinical examination and vaginal ultrasonography 3, 6, and 12 months after surgery and subsequently at least once a year. We evaluated the cumulative recurrence rate of pain and clinical findings of ovarian endometrioma, the rate of repeated surgery, and the recovery of fertility.ResultsDuring follow-up we observed ultrasonographic recurrence in 26 (7.1%) cases; surgery was repeated in 12 (3.3%) cases. The cumulative rate of ultrasonographic recurrence over 48 months was 11.7%, whereas the cumulative rate of a second surgery was 8.2%. Ultrasonographic cyst recurrence was associated with pain recurrence in 73% of cases, whereas in the remaining 27% the recurrence was asymptomatic. Significant factors related to recurrence of endometriomas would appear to be the stage of disease (P =.03) and previous surgery for endometriosis (P =.003). Eighty-five (23.2%) women conceived during follow-up.ConclusionsLaparoscopic treatment of endometriomas seems to be both effective and reliable. The rate of recurrence appears to be correlated to the duration of follow-up. Stage IV disease and previous surgery for endometriosis are unfavorable prognostic factors.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Endometriosis Ovarian Diseases Ovarian Diseases Adult Disease Progression Endometriosis Endometriosis Female Follow-Up Studies Humans Italy Laparoscopy Ovarian Diseases Ovarian Diseases Prospective Studies Recurrence Treatment Outcome Ultrasonography

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