Laparoscopic surgery for endometriosis: How often do we need to re-operate?

Abstract

This study aimed to examine the rate of re-operation in women with endometriosis over a 10-year period. This was a retrospective study set in a university hospital in the UK. Notes of all women diagnosed with endometriosis were reviewed and data entered on a standard proforma. A total of 486 out of 988 procedures were for treatment of endometriosis. Some 240 (49%) had pelvic pain and 246 (51%) had subfertility. The mean age of those women who had a re-operation was lower than those who did not have any further operations. Using logistic regression, three factors were found to be the most important factors influencing the likelihood of women having re-operation - in decreasing order of importance, these factors were: (1) age, (2) pregnancy achievement and (3) improvement of symptoms. Re-operation occurred in 51% of our study population, the information may be useful for guidance of our patients.

Does Controlled Ovarian Hyperstimulation in Women with a History of Endometriosis Influence Recurrence Rate?

“…In a recent study evaluating reoperation rates over a 10-year period, 51% of patients underwent an additional operation after the initial surgery. 4 In the present study, there was a noticeable reduction of reoperation rates. This could be explained by the fact that our study selected women with subfertility problems who subsequently achieved pregnancy.…”

“…3,4 This wide range may, in part, be ascribed to different criteria for the definition of recurrence, a lack of long-term follow-up studies, and a lack of homogeneous groups. Most of the published studies to date have focused on recurrence rates after short or intermediate periods.…”

“…2 The recurrence rate in women who undergo conservative surgery for endometriosis ranges from 2% to 51%. 3,4 Some authors suggest that the risk of recurrence tends to rise with further age and advanced stages of the disease, whereas it lessens in women with infertility. 3 These data are still controversial, however.…”

Long-term follow-up after laparoscopic treatment for endometriosis: multivariate analysis of predictive factors for recurrence of endometriotic lesions and pain

“…Laparoscopic excision of endometriosis results in pain relief, improved reproductive outcomes, and increased quality of life. Unfortunately, even with surgeons experienced in laparoscopy, 6-51% of women will have a recurrence of endometriosis within 5 years of surgery [3,4].…”

Influence of Ovarian Endometrioma on Expression of Steroid Receptor RNA Activator, Estrogen Receptors, Vascular Endothelial Growth Factor, and Thrombospondin 1 in the Surrounding Ovarian Tissues

“…48 The fact suggests that conservative surgical treatment does remove endometriotic tissues but not change predisposing factors and basal molecular defects for endometriosis. The present study supported this view that, after surgical removal of endometriotic tissue, the surrounding ovarian tissues with molecular defects, including upregulation of SRA and ERs, may demonstrate the predisposition for endometriosis, especially when abnormal eutopic endometrium 49,50 which is similar to that of preoperation goes into the peritoneal cavity.…”