Risk factors for postoperative recurrence of ovarian endometriosis: long-term follow-up of 358 women

Abstract

Objective To explore the risk factors for the recurrence of endometrioma and the risk factors for the recurrence of endometriosis-related pain after long-term follow-up. Methods This study retrospectively analyzed 358 women with endometriomas who had a minimum of 5-years follow up after laparoscopic endometrioma excision, which was performed at Peking Union Medical College Hospital from January 2009 to April 2013. All women were divided into recurrence group and nonrecurrence group. Analysis was performed with regard to preoperative history, laboratory analysis, findings during surgery, and symptoms during follow-up, including improvement and recurrence. Results The cumulative incidence rates of recurrence from 5 to 10 years after surgery were 15.4, 16.8, 19.3, 22.5, 22.5, and 22.5%, respectively. Significant differences were found between two groups in terms of age at surgery (RR: 0.764, 95% CI: 0.615–0.949, p = 0.015), duration of dysmenorrhea (RR: 1.120, 95% CI: 1.054–1.190, p < 0.001), presence of adenomyosis (RR: 1.629, 95% CI: 1.008–2.630, p = 0.046), CA125 level (RR: 1.856, 95% CI: 1.072–3.214, p = 0.021) and severity of dysmenorrhea. The severity of dysmenorrhea (RR: 1.711, 95% CI: 1.175–2.493, p = 0.005) and postoperative pregnancy (RR: 0.649, 95% CI: 0.460–0.914, p = 0.013) were significantly correlated with endometrioma recurrence in the multivariate analysis. No significant associations were found between the recurrence rate and gravida, parity, body mass index, infertility, leiomyoma presence, the size of ovarian endometrioma, the presence of deep infiltrating endometriosis, disease stage or postoperative medication. Conclusions The severity of dysmenorrhea and postoperative pregnancy were independent risk factors for the recurrence of ovarian endometriomas after surgery during the long-time follow up.

Recurrence Rate and Risk Factors for the Recurrence of Ovarian Endometriosis after Laparoscopic Ovarian Cystectomy

“…Han et al reported that the age of patients at the time of OE surgery had a correlation with the recurrence rate [ 9 ]. Han's work showed similar conclusions with Moini's and Yuan's works [ 6 , 7 , 9 ]. However, this current finding found no correlation that younger patients were correlated with the OE recurrence factor.…”

Atypical endometriosis is related to a higher recurrence rate

“…Second, our study included women who conceived after their initial surgery. According to several previous studies, postoperative pregnancy prevents the recurrence of endometriosis [17,31,32]. Although there were no significant differences in the proportion of women who conceived after surgery between AE and TE groups, it may affect results.…”

Laparoscopic Outcomes after Normal Clinical and Ultrasound Findings in Young Women with Chronic Pelvic Pain: A Cross-Sectional Study

“…There is a dearth of reliable evidence to suggest delay in diagnosis or early medical intervention may affect the long-term clinical outcomes of endometriosis. There are some studies suggesting higher rates of recurrent disease in younger women after surgical treatment, when compared with older women [36][37][38], thus future well-designed, prospective, large-scale studies with long-term follow-up are required to assess the benefit of surgical intervention for endometriosis, particularly in younger women.…”