Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study
Received 29 July 2008; received in revised form 6 October 2008; accepted 9 October 2008. published online 04 December 2008.
Objective
To identify prognostic factors for pain and endometrioma recurrence after complete laparoscopic excision of endometrioma(s).
Design
Prospective observational study.
Setting
Tertiary care university hospital.
Patient(s)
One-hundred sixty-six consecutive women affected by uni- or bilateral ovarian endometrioma(s).
Intervention(s)
Laparoscopic conservative treatment of endometriosis.
Main Outcome Measure(s)
Patient demographic characteristics, surgical findings, and surgical results were prospectively recorded. Postoperative follow-ups were carried out every 3 months to identify pain and/or endometrioma recurrence for a minimum of 3 years.
Result(s)
Dysmenorrheal, dyspareunia, and chronic pelvic pain recurred in 14.5%, 6%, and 5.4% of women, respectively. Prior surgery for endometriosis, adhesion extension, and use of ovarian stimulation drugs (OSD) were unfavorable prognostic factors for pain symptoms. Ovarian endometrioma recurred in 9.6% of cases; negative factors were prior surgery for endometriosis, OSD, pelvic adhesions, and high American Society for Reproductive Medicine disease scores. Postoperative pregnancy showed a significant protective effect on pain and disease recurrences.
Conclusion(s)
Prior surgery, presence of adhesions, and ovulation drugs are negative prognostic factors. Pregnancy has a protective effect on disease and pain recurrence.
Department of Gynecology and Obstetrics, University of Rome “Sapienza,” Rome, Italy
Reprint requests: Maria Grazia Porpora, M.D., Department of Gynecology and Obstetrics, University of Rome “Sapienza,” Viale Regina Elena, 324–00161—Roma, Italy (FAX: +39 06 4450368).
M.G.P. has nothing to disclose. D.P. has nothing to disclose. A.F. has nothing to disclose. B.C. has nothing to disclose. F.B. has nothing to disclose. P.B. has nothing to disclose.
ABSTRACT