Ovarian stripping versus cystectomy: recurrence of endometriosis and pregnancy rate
Abstract
Purpose To compare two different surgical techniques, stripping or cystectomy, in patients treated with the same post-operative medical therapy in terms of recurrence of endometrioma, recurrence of pain and spontaneous pregnancy rate within 2 years from surgery.Methods The inclusion criteria of this study were: (1) 25-40 years old; (2) ovarian endometrioma more than 3 cm of diameter detected by transvaginal ultrasonography (3) regular menstrual cycle (4) post-operative treatment with GnRH analogs, (5) tubal patency assessed by laparoscopic chromopertubation (6) normal human semen characteristics. Exclusion criteria were uterine myoma, previous medical treatment for endometriosis, presence of adenomyosis, previous surgery of ovarian endometrioma, multiple cysts, bilateral involvement, co-existence of deep endometriosis. Patients were assigned to two study groups: group A (N = 45) patients undergoing stripping technique and group B (N = 64) patients undergoing cystectomy technique for ovarian endometrioma.Results In group B the percentage of ultrasonographic recurrence (15.4 %, N = 15) is much lower than in group A (55.6 %, N = 25). (p value 0.001). In group B the percentage of symptomatic recurrence (21.8 %, N = 14) is much lower than in group A (53.3 %, N = 24) (p value 0.001). Spontaneous pregnancy rate in group A patients was of 4.4 % (N = 2) and in group B 22.3 % (N = 21), (p value 0.0072). However, the percentage of specimen with adjacent healthy ovarian tissue was lower in group A (26.6 %) than in group B (50 %) (p value 0.01).Conclusions Among the different treatment options for surgical treatment of ovarian endometrioma, in our experience cystectomy appears to be the most appropriate treatment, both in terms of recurrence and pregnancy rate.
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Recurrence rates of cystic ovarian endometriosis after stripping are less than 20% within 6 months but vary with the surgeon and the technique used.
“Recurrence rates of cystic ovarian endometriosis after stripping are less than 20% within 6 months (61, 62) but vary with the surgeon (63) and the technique used.”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [62]
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- Authors
- Moscarini, M., Milazzo, G. N., Assorgi, C., Pacchiarotti, A., & Caserta, D.
- Affiliations
- Azienda Ospedaliera Sant'Andrea (IT)
- Corresponding author
- Caserta, Donatella
- Venue
- Archives of Gynecology and Obstetrics
- Published
- 2014-02-01
- Volume
- 290
- Issue
- 1
- Pages
- 163-167
- ISSN
- 0003-9128 (ISSN-L)
- 0932-0067
- 1432-0711
- OpenAlex
- W1973125038
- Cited by
- 20
- References
- 33
- Citations by year
- 2025: 2 · 2024: 1 · 2022: 3 · 2020: 4 · 2019: 1 · 2018: 1 · 2016: 4 · 2015: 4
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Update notices
- expression_of_concern (2026-08-06)
- Open access
- closed
- Licence
- Locations
- Archives of Gynecology and Obstetrics (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometrioma, cystectomy, endometriosis recurrence, spontaneous pregnancy rate, GnRH analogues, postoperative medical therapy, symptom recurrence, ovarian tissue preservation, tubal patency
- MeSH terms
- Adult, Endometriosis, Female, Humans, Gonadotropin-Releasing Hormone, Ovarian Diseases, Laparoscopy, Pregnancy, Recurrence, Gynecologic Surgical Procedures, Ultrasonography, Cystectomy, Treatment Outcome, Pelvic Pain, Pregnancy Rate
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