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 ≥ 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.
| Original language | English |
|---|---|
| Pages (from-to) | 694-699 |
| Number of pages | 6 |
| Journal | Fertility and Sterility |
| Volume | 85 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2006 |
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Keywords
- Endometriosis
- Ovarian cysts
- Ovarian endometrioma
- Recurrent endometriosis
ASJC Scopus subject areas
- Obstetrics and Gynaecology
Cite this
Laparoscopic excision of recurrent endometriomas : Long-term outcome and comparison with primary surgery. / Fedele, Luigi; Bianchi, Stefano; Zanconato, Giovanni; Berlanda, Nicola; Raffaelli, Ricciarda; Fontana, Eleonora.
In: Fertility and Sterility, Vol. 85, No. 3, 03.2006, p. 694-699.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic excision of recurrent endometriomas
T2 - Long-term outcome and comparison with primary surgery
AU - Fedele, Luigi
AU - Bianchi, Stefano
AU - Zanconato, Giovanni
AU - Berlanda, Nicola
AU - Raffaelli, Ricciarda
AU - Fontana, Eleonora
PY - 2006/3
Y1 - 2006/3
N2 - 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 ≥ 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.
AB - 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 ≥ 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.
KW - Endometriosis
KW - Ovarian cysts
KW - Ovarian endometrioma
KW - Recurrent endometriosis
UR - http://www.scopus.com/inward/record.url?scp=32944461402&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=32944461402&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2005.08.028
DO - 10.1016/j.fertnstert.2005.08.028
M3 - Article
C2 - 16500340
AN - SCOPUS:32944461402
VL - 85
SP - 694
EP - 699
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 3
ER -