Risk factors for ovarian endometrioma recurrence following surgical excision: a systematic review and meta‑analysis

Jiang, Dongliang; Zhang, Xuxing; Shi, Jiaqi; Tao, Dongmei; Nie, Xiaocui

doi:10.1007/s00404-021-06129-0

Cited by 14 publications

(10 citation statements)

References 42 publications

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“…According to multivariate analysis of our study, the presence of dysmenorrhea is an independent risk factor for postoperative recurrence of ovarian endometriosis. This is consistent with those of several studies [ 15 – 17 ]. In addition, not only the presence but also the severity of dysmenorrhea was an independent risk factor for postoperative recurrence of endometrioma [ 14 ].…”

Section: Discussionsupporting

confidence: 94%

“…Libo Zhu et al found that the recurrence rate of AM combined with EM at 6 years after operation was higher than that of AM alone group [ 22 ], indicating that EM and AM influenced each other. However, some studies found that the effect of AM on the recurrence of endometrioma was not statistically significant [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies came to the same conclusion: younger age at surgery was a risk factor for recurrence [ 16 , 23 , 24 ]. Meta-analysis showed that younger age was a high risk factor for recurrence of endometrioma after conservative surgery [ 15 , 25 ]. Nozomi Ouchi et al analyzed patients with untreated endometrioma after surgery and found that age < 32 years old is a risk factor for postoperative endometrioma recurrence [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Status and related factors of postoperative recurrence of ovarian endometriosis: a cross-sectional study of 874 cases

Yang

Bao

Tian

et al. 2023

Arch Gynecol Obstet

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Purpose Exploring the status and related factors of postoperative recurrence of ovarian endometriosis. Methods This study analyzed the results of questionnaires conducted in 27 hospitals across the country from January 2019 to November 2021. All women were divided into recurrence group and non-recurrence group to analyze the recurrence rate and related factors after ovarian endometriosis surgery. Results The recurrence rates of ovarian endometriosis within 1 year, 1–2 years, 2–3 years, 3–4 years, 4–5 years and more than 5 years were 6.27%, 35.85%, 55.38%, 65.00% and 56.82%, respectively. Significant differences were found between two groups in terms of age at surgery (OR: 0.342, 95%CI: 0.244–0.481, P < 0.001), presence of dysmenorrhea (OR: 1.758, 95%CI: 1.337–2.312, P < 0.001), presence of adenomyosis (OR: 1.948, 95%CI: 1.417–2.678, P < 0.001) and family history of endometriosis or adenomyosis (OR: 1.678, 95%CI: 1.035–2.721, P = 0.021). The age at surgery (OR: 0.358, 95%CI: 0.253–0.506, P < 0.001), presence of dysmenorrhea (OR: 1.379, 95%CI: 1.026–1.853, P = 0.033) and presence of adenomyosis (OR: 1.799, 95%CI: 1.275–2.537, P = 0.001) were significantly associated with endometrioma recurrence in multivariate analysis. No significant associations were found between the recurrence rate and body mass index (BMI), educational background, age of menarche, gravida, parity, uterine leiomyoma, endometrial polyps or postoperative use of gonadotropin-releasing hormone agonist (GnRH-a). Conclusions Dysmenorrhea and presence of adenomyosis are independent risk factors for postoperative recurrence of ovarian endometriosis, and older age is an independent protective factor for postoperative recurrence.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Status and related factors of postoperative recurrence of ovarian endometriosis: a cross-sectional study of 874 cases

Yang

Bao

Tian

et al. 2023

Arch Gynecol Obstet

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“…For many years, the most appropriate treatment of OMA was considered the surgical approach, 32 but this view changed 24 with the accumulated evidence of adverse effects induced by surgery on ovarian reserve 33 – 35 and the high rate of OMA recurrence, nearly 40%–50% at 5 years. 36 The improvement in ultrasonography and sonographers’skills led to an earlier detection of OMA recurrence, when they are smaller, less fibrotic, and more responsive to medical therapy, 37 which can help reduce the risk of subsequent surgery. 26 , 38 Many authors have shown that OMA per se can impair the ovarian function because endometriotic cysts have been reported to contain high levels of reactive oxygen species (ROS), iron, inflammatory molecules, and cellular damaging factors.…”

Section: Discussionmentioning

confidence: 99%

Long-term therapy with dienogest or other oral cyclic estrogen-progestogen can reduce the need for ovarian endometrioma surgery

Ferrari,

Epis,

Casarin

et al. 2024

Womens Health (Lond Engl)

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Background: Almost 10% of women in reproductive age are diagnosed with ovarian endometriomas and can experience symptoms and infertility disorders. Ovarian endometriomas can be treated with medical or surgical therapy. Objective: To assess whether long-term therapy with dienogest or oral cyclic estrogen-progestogens is effective in reducing the size of ovarian endometriomas, alleviating associated symptoms, and reducing the requirement for surgery. Design: Prospective non-interventional cohort study. Methods: We enrolled childbearing women diagnosed with ovarian endometriomas. We collected demographic, clinical, and surgical data, including the evaluation of ovarian endometrioma-associated symptoms and pain using the visual analog scale. We grouped the women according to treatment regimen into dienogest, estrogen-progestogens, and no-treatment. Patient’s assessment was performed at baseline and after 12 months evaluating the largest ovarian endometrioma diameter (in millimeters) and the associated symptoms. Furthermore, we analyzed the impact of hormonal treatment in a sub-group of women fulfilling at baseline the criteria for a first-line surgical approach (ovarian endometrioma > 30 mm with visual analog scale > 8 or ovarian endometrioma > 40 mm before assisted reproductive treatments or any ovarian endometrioma(s) > 60 mm). Results: We enrolled 142 patients: 62, 38, and 42 in dienogest, estrogen-progestogens, and no-treatment groups, respectively. No significant differences were found regarding baseline characteristics. After 12 months, the mean largest ovarian endometrioma diameter increased in the no-treatment group (31.1 versus 33.8; p < 0.01), while a significant reduction was registered in the dienogest (35.1 versus 25.8; p < 0.01) and estrogen-progestogens (28.4 versus 16.7; p < 0.01) groups; no significant difference in ovarian endometrioma diameter reduction between these two latter groups was noted (p = 0.18). Ovarian endometrioma-associated symptoms and pain improved in dienogest and estrogen-progestogens groups, with a significantly greater effect for dienogest than for estrogen-progestogens for dysmenorrhea (74% versus 59%; p < 0.01). In the sub-group of women eligible for first-line surgery at baseline, long-term treatment with dienogest and estrogen-progestogens reduced surgical eligibility by 30%. Conclusions: Decreased mean largest ovarian endometriomas’diameter after 12 months and reduction of the need for surgical treatment by 30% were observed in dienogest and estrogen-progestogens groups. Long-term treatment with dienogest had a greater effect in alleviating dysmenorrhea and pain.

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“…Meanwhile, surgery, such as ovarian cystectomy, is the standard therapy for endometrioma. 2,3 However, surgical procedures still have a risk of recurrence. Endometrioma recurrence may be due to growth of residual lesions or retrograde menstruation after surgery.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Endometrioma Recurrence Patients

Maharani,

Bayuaji,

Syam

et al. 2023

Obgynia

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Objective: To identify the characteristics of endometrioma recurrence cases. Method: This study was a descriptive retrospective, using secondary data taken from all medical records of Clinic Aster and Medical Records Installation in Dr. Hasan Sadikin General Hospital, Bandung, from 1st January 2018 – 31st December 2022. Data were presented in tables.Results: Of the 37 endometrioma recurrences, most of the patients are 20 to 35 in age. None of them has a parity history after the first surgical procedure. Both previous and recent cases are dominantly unilateral endometriomas. The history of postoperative medication is higher (54,1%). Obstetricians/Gynecologists appear to perform the most surgical procedure (67,6%). Mass is the main clinical manifestation of the recurrence. While menstrual and BMI profiles appear to be normal.Conclusions: The characteristic of the recurrence of endometrioma is related parity status after the first surgery, history of the previous medical treatment, and previous form of endometrioma are related to the current characteristic of endometrioma (age, lesion form, clinical manifestation, and recurrence interval).Karakteristik Pasien Endometrioma RekurenAbstrakTujuan: Mengetahui karakteristik dari pasien endometrioma rekuren.Metode: Penelitian ini merupakan penelitian deskripsi retrospektif dengan menggunakan data sekunder yang diambil dari seluruh rekam medis pasien kista endometriosis rekuren di Klinik Aster dan Instalasi Rekam Medis di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dengan periode 1 Januari 2018 – 31 Desember 2022. Kemudian, data-data disajikan dalam bentuk tabel. . Hasil: Dari 37 kasus e ndometrioma rekuren, sebagian besar pasien berusia 20 hingga 35 tahun. Seluruh pasien tidak mempunyai riwayat paritas setelah prosedur pembedahan sebelumnya. Baik kasus-kasus kista endometriosis sebelumnya maupun yang kambuh, keduanya dominan dalam bentuk unilateral. Riwayat pengobatan pasca operasi lebih tinggi (54,1%). Dokter Spesialis Obstetri/Ginekologi tampak melakukan tindakan pembedahan terbanyak (67,6%). Massa adalah manifestasi klinis utama dari kekambuhan. Selain itu, profil menstruasi dan BMI tampak normal.Kesimpulan: Karakteristik pada endometrioma rekuren berkaitan dengan status paritas setelah operasi pertama, riwayat pengobatan medis sebelumnya, dan bentuk endometrioma sebelumnya berhubungan dengan karakteristik endometrioma saat ini (usia, bentuk lesi, manifestasi klinis, dan rentang rekurensi)Kata kunci: karakteristik, rekuren, endometrioma

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Risk factors for ovarian endometrioma recurrence following surgical excision: a systematic review and meta‑analysis

Cited by 14 publications

References 42 publications

Status and related factors of postoperative recurrence of ovarian endometriosis: a cross-sectional study of 874 cases

Status and related factors of postoperative recurrence of ovarian endometriosis: a cross-sectional study of 874 cases

Long-term therapy with dienogest or other oral cyclic estrogen-progestogen can reduce the need for ovarian endometrioma surgery

Characteristics of Endometrioma Recurrence Patients

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