Laparoscopic excision of recurrent endometriomas: long-term outcome and comparison with primary surgery
Open accessAbstract
Objective To compare the laparoscopic excision of primary versus recurrent ovarian endometriomas. Design Descriptive study. Setting Tertiary referral center for the treatment of endometriosis. Patient(s) Between 1993 and 2002, 359 consecutive patients: 305 primary surgeries (group A) and 54 reoperations for a recurrent endometrioma in the same ovary of the primary cyst (group B). Intervention(s) Laparoscopic stripping of the cyst wall. Follow-up evaluations every 6 months, including clinical and ultrasonographic evaluations and a questionnaire for pain symptoms (mean follow-up time, +/- standard deviation: 35.4 +/- 27.6 months). Main outcome measure(s) Recurrence of pain symptoms, sonographic recurrence of endometriomas, need for a new medical or surgical treatment, and reproductive outcome. Result(s) In groups A and B, respectively, the 5-year cumulative rates were not statistically significantly different: pain recurrence 20.5% versus 17.4%; ultrasonographic recurrence 18.9% versus 15.1%; retreatment requirement 19.4% versus 17.3%; and pregnancy 40.8% versus 32.4%. Although the difference was not statistically significant, compared with patients of group A, the women of group B underwent assisted reproduction techniques more frequently (50% vs. 32.2%) and had more irregular menstrual cycles associated with follicle-stimulating hormone levels > or = 14 IU/mL in the early follicular phase (5.5% vs. 1.3%). Conclusion(s) After laparoscopic excision of recurrent ovarian endometriomas, the recurrence of pain and the reproductive outcome are comparable with those found after primary surgery.
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Women who underwent repeat surgery for ovarian endometriomas reported more irregular menstrual cycles associated with FSH concentrations ≥14 UI/ml.
“Women who underwent repeat surgery were more likely to need assisted conception and reported more irregular menstrual cycles associated with FSH concentrations ≥14 UI/ml (Fedele et al., 2006; Gelbaya and Nardo, 2011).”
From When more is not better: 10 ‘don’ts’ in endometriosis management. An ETIC* position statement (2019) · cites this paper as Fedele et al., 2006
Women who underwent repeat surgery for ovarian endometriomas were more likely to need assisted conception.
“Women who underwent repeat surgery were more likely to need assisted conception and reported more irregular menstrual cycles associated with FSH concentrations ≥14 UI/ml (Fedele et al., 2006; Gelbaya and Nardo, 2011).”
From When more is not better: 10 ‘don’ts’ in endometriosis management. An ETIC* position statement (2019) · cites this paper as Fedele et al., 2006
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Investigation of tubal and peritoneal causes of infertility
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Cirugía de la endometriosis anexial
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ENDOMETRIOSIS, ENDOMETRIOMA AND INFERTILITY
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- Authors
- Fedele, L., Bianchi, S., Zanconato, G., Berlanda, N., Raffaelli, R., & Fontana, E.
- Affiliations
- University of Milan (IT)
- University of Verona (IT)
- Corresponding author
- Fedele, Luigi
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2006-03
- Volume
- 85
- Issue
- 3
- Pages
- 694-699
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W1977520875
- Cited by
- 97
- References
- 16
- Citations by year
- 2026: 4 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 10 · 2014: 3 · 2013: 9 · 2012: 4
- FWCI
- 8.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- 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
- laparoscopic resection, primary surgery, reoperation, endometriosis, pain recurrence, endometrioma recurrence, reproductive outcomes, pregnancy, assisted reproduction, follicle-stimulating hormone, menstrual irregularity
- MeSH terms
- Adult, Endometriosis, Female, Humans, Longitudinal Studies, Ovarian Diseases, Pain, Laparoscopy, Pregnancy, Recurrence, Gynecologic Surgical Procedures, Survival Analysis, Treatment Outcome, Pregnancy Rate, Retreatment
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