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Laparoscopic excision of recurrent endometriomas: long-term outcome and comparison with primary surgery.

Abstract：

OBJECTIVE:To compare the laparoscopic excision of primary versus recurrent ovarian endometriomas. DESIGN:Descriptive study. SETTING:Tertiary referral center for the treatment of endometriosis. PATIENT(S):Between 1993 and 2002, 359 consecutive patients: 305 primary surgeries (group A) and 54 reoperations for a recurrent endometrioma in the same ovary of the primary cyst (group B). INTERVENTION(S):Laparoscopic stripping of the cyst wall. Follow-up evaluations every 6 months, including clinical and ultrasonographic evaluations and a questionnaire for pain symptoms (mean follow-up time, +/- standard deviation: 35.4 +/- 27.6 months). MAIN OUTCOME MEASURE(S):Recurrence of pain symptoms, sonographic recurrence of endometriomas, need for a new medical or surgical treatment, and reproductive outcome. RESULT(S):In groups A and B, respectively, the 5-year cumulative rates were not statistically significantly different: pain recurrence 20.5% versus 17.4%; ultrasonographic recurrence 18.9% versus 15.1%; retreatment requirement 19.4% versus 17.3%; and pregnancy 40.8% versus 32.4%. Although the difference was not statistically significant, compared with patients of group A, the women of group B underwent assisted reproduction techniques more frequently (50% vs. 32.2%) and had more irregular menstrual cycles associated with follicle-stimulating hormone levels > or = 14 IU/mL in the early follicular phase (5.5% vs. 1.3%). CONCLUSION(S):After laparoscopic excision of recurrent ovarian endometriomas, the recurrence of pain and the reproductive outcome are comparable with those found after primary surgery.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Fedele L,Bianchi S,Zanconato G,Berlanda N,Raffaelli R,Fontana E

doi

10.1016/j.fertnstert.2005.08.028

keywords:

subject

Has Abstract

pub_date

2006-03-01 00:00:00

pages

694-9

issue

3

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(05)03943-9

journal_volume

85

pub_type

杂志文章

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