Recurrence rate of endometriomas following a laparoscopic cystectomy

Kikuchi, Iwaho; Takeuchi, Hiroyuki; Kitade, Mari; Shimanuki, Hiroto; Kumakiri, Jun; Kinoshita, Katsuyuki

doi:10.1080/00016340600627154

Cited by 105 publications

(66 citation statements)

References 11 publications

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“…''Unfortunately, there is no permanent cure for this condition, so it often requires a life-long management plan with the goal of maximizing the use of medical treatment and avoiding repeated surgical procedures'', reports the American Society of Reproductive Medicine [3]. Lesions and symptoms very frequently return after medication is discontinued or after conservative surgery is performed, a fact which frustrates both patients and clinicians [4] and is estimated to occur in 30-50 % of cases within 2-5 years [2,[5][6][7][8][9][10]. The American College of Obstetricians and Gynecologists Practice Bulletin suggests that the true recurrence rate must be even higher than the rate generally reported in literature, because most publications report symptomatic disease only [11].…”

Section: Introductionmentioning

confidence: 99%

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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Objective The primary aim of the study was to analyze the endometrioma recurrence rate in patients who underwent laparoscopic excision followed by postoperative longterm regimen of oral contraceptives (OCs). Materials and methods 168 patients who underwent a conservative laparoscopic surgery for endometrioma, during the period between September 2009 and August 2010 in three university hospitals were studied. A long-term OCs therapy was offered to all women following surgery. Patients were randomly divided into three groups according to different progestins used (desogestrel, gestodene, dienogest). Women who refused a postoperative hormonal therapy served as control. Follow-up visits and transvaginal scan were planned at 1, 3, 6, 12, and 24 months after surgery. All patients who showed an ultrasound persistence of the endometrioma at 1 month follow-up were excluded from clinical analysis.Results Of the 168 patients, 131 completed the 24 months follow-up. Endometrioma recurrence was found in 21 (12.5 %) of all patients, it was unilateral in 17 cases while bilateral in 4 cases. The rate of recurrent endometrioma was statistically significant in non-users compared to the long-term OCs treated patients. Conclusion The current data suggest the usefulness of long-term OCs regimen after conservative surgery for the prevention of ovarian endometrioma recurrence. As a statistical significant difference could not be observed between OCs groups, further study on the individual molecules is required in order to really understand the effect of each of them.

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Section: Introductionmentioning

confidence: 99%

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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“…The surgical procedure for endometriosis used in our department has previously been described elsewhere. Briefly, we routinely performed the 4-puncture method under general anesthesia by endotracheal intubation in the lithotomy position [15,16]. In cases with endometriomas, we excised ovarian cyst walls-the so-called ''striping method''-and sewed purse-string sutures with Vicryl Ò 2-0 (Ethicon, Japan) in consideration of potential damage to the ovarian reserve.…”

Section: Laparoscopic Proceduresmentioning

confidence: 99%

The impact of endometriosis, endometrioma and ovarian cystectomy on assisted reproductive technology

Kuroda

Kitade

Kikuchi

et al. 2009

Reprod Medicine & Biology

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Purpose To assess outcomes in assisted reproductive technology (ART) in infertile women with endometriosis with respect to their concomitant endometrioma status and surgical history in our department. Methods This is a retrospective case control study which analyzes informational data obtained at a university hospital. The study drew from a patient pool of 332 cases (877 cIVF/ICSI cycles) that took place in our department from 2006 to 2008. Sixty-one cases (97 cycles) had major indications for cIVF/ICSI with endometriosis. We classified groups from these 61 cases as follows: an unoperated endometrioma group (A) with 31 cycles, a postoperative endometrioma group (B) with 51 cycles, and a no endometrioma group (C) with 15 cycles. We analyzed and compared these three groups and also included a nonendometriosis tubal infertility group (D) with 27 cycles. Results In the control group (D), serum FSH levels and the cancellation rates were significantly lower than those of other groups, and the number of developing follicles was higher. E2 levels before oocyte aspiration in the postoperative endometrioma group (B) was lower. Implantation, pregnancy, delivery and miscarriage rates were not significantly different among the four groups. Conclusion The results suggest that endometriosis causes a decrease in endocrinologic ovarian function whether or not an endometrioma is also present. As for E2 level before oocyte aspiration, our results suggest that ovarian reserves might be reduced by endometrioma excision, but this is difficult to evaluate. In the endometriosis groups, cancellation rates were significantly higher, although when embryos were transferred the pregnancy rates were not significantly different when compared with the non-endometriosis group. As for infertile women with endometriomas, our results suggest that preexisting ovarian reserve is reduced by the presence of endometriosis, and ovarian reserve might also be reduced by excision of endometriomas.

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“…Vercellini et al reported that the use of GnRH analogs prevents the risk of recurrence after surgery in patients with moderate or severe endometriosis (25). In contrast, some studies have been unsuccessful to show any evidence about the effects of post-operative medication in reducing endometriosis recurrence (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39). Recent findings demonstrated that post-surgical hormonal therapy for endometriosis has no improvement on pain relief or pregnancy rates, but a substantial decrease in endometriosis recurrence rate solely (30).…”

Section: Discussionmentioning

confidence: 99%

Effect of Amygdalin on the treatment and recurrence of endometriosis in an experimental rat study

Doğru¹

2017

Period. Biol.

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Recurrence rate of endometriomas following a laparoscopic cystectomy

Abstract: Young age and severe endometriosis appeared to be the factors associated with high recurrence risk. Recurring ovarian endometrimas probably include cysts occurring spontaneously and those recurring from the cyst residues in the lesions where cystectomy has been performed.

Cited by 105 publications

References 11 publications

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

The impact of endometriosis, endometrioma and ovarian cystectomy on assisted reproductive technology

Effect of Amygdalin on the treatment and recurrence of endometriosis in an experimental rat study

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