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Large ovarian endometriomas
Abstract
The management of large endometriomas was described in a series of 814 patients. Combined therapy using gonadotrophin-releasing hormone agonist (GnRHa) and carbon dioxide laser laparoscopy was proposed. Drainage and GnRHa for 12 weeks provoked a reduction of the endometrioma size up to 50% of the initial value. After vaporization of the internal wall, a cumulative pregnancy of 51% after 1 year was achieved. A recurrence rate of 8% was observed for a follow-up of 2-11 years. Histological data demonstrated that the epithelium covering the ovary which is the mesothelium can invaginate in the ovarian cortex. Some of the invaginations were seen to be continuous with endometrial tissue, strongly suggesting the metaplasia theory in the pathogenesis of ovarian endometrioma.
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“the impact of progestogens on the morphology and vascularization of ectopic endometrial tissue and atrophy is much more questionable [77,78,79,80,81].”
From Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review (2021) · cites this paper as [78]
In the citing paper
“Some studies have revealed the absence of proliferation index changes under progestogen therapy [77,78,79,80,81].”
From Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review (2021) · cites this paper as [78]
In the citing paper
“The reduction in lesion volume is not predictable and not significant in the vast majority of cases. Conflicting results have been observed [77,78,79,80,81,82,86,87,88].”
From Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review (2021) · cites this paper as [78]
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Research works printed but not linked: 4
- Brosens, I. (1995a) Ovarian endometriosis. In Shaw, R. (ed.), Endometriosis. Parthenon Publishing, London, Camforth, p.
- Canis, M., Wattiez, A., Pouly, J.L. et al. (1993) Laparoscopic treatment of endometriosis. In Brosens, I. and Donnez, J. (eds), The Current Status of Endometriosis. Research and Management. Parthenon Publishing, Camforth, UK, pp. 407-417.
- Donnez, J. (1993) Rationale for surgery. In Brosens, I. and Donnez, J. (eds). Current Status of Endometriosis. Research and Management, Vol. L Parthenon Publishing, Carnforth, UK, pp. 385-395.
- Gabe, M. (1968) Les colorations topographiques. In Masson and Co. (eds). Techniques Histologiques, Paris, pp. 203-256.
Cited by
Sorted by citations
Nisolle, M., & Donnez, J. (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)00191-x · Cited by 1,279
Endometriosis and infertility: a committee opinion
(2012) · Fertility and Sterility · doi:10.1016/j.fertnstert.2012.05.031 · Cited by 633
“While these and other observational studies suggest that, in women with Stage III/IV endometriosis who have no other identifiable infertility factors, conservative surgical treatment with laparoscopy and possible laparotomy may increase fertility (29), a possible adverse consequence is the loss of viable ovarian corte…”
ResultExcisional surgery versus ablative surgery for ovarian endometriomata
Hart, R. J., Hickey, M., Maouris, P., & Buckett, W. M. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004992.pub3 · Cited by 470
Sanchez, A. M., Viganò, P., Somigliana, E., Panina-Bordignon, P., Vercellini, P., & Candiani, M. (2014) · Human Reproduction Update · doi:10.1093/humupd/dmt053 · Cited by 357
“Donnez et al. (1996) have studied biopsies from 814 ovarian cysts.”
BackgroundInfluentialSomigliana, E., Viganò, P., Parazzini, F., Stoppelli, S., Giambattista, E., & Vercellini, P. (2006) · Gynecologic Oncology · doi:10.1016/j.ygyno.2005.11.033 · Cited by 296
“The precise prevalence of these alterations in endometriosis and their significance in terms of risk to undergo malignant transformation are not defined [12,14,16–19].”
Background
Metadata
- Authors
- Donnez, J., Nisolle, M., Gillet, N., Smets, M., Bassil, S., & Casanas-Roux, F.
- Affiliations
- Cliniques Universitaires Saint-Luc (BE)
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 1996-03-01
- Volume
- 11
- Issue
- 3
- Pages
- 641-645
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W1971732433
- Cited by
- 360
- References
- 0
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 12 · 2023: 9 · 2022: 8 · 2021: 15 · 2020: 17 · 2019: 12 · 2018: 17 · 2017: 16 · 2016: 11 · 2015: 15 · 2014: 14 · 2013: 20 · 2012: 11
- FWCI
- 7.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (submittedVersion)
- Open Repository and Bibliography (University of Liège) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- endometrioma, GnRH agonist, carbon dioxide laser vaporization, laparoscopic surgery, pregnancy rate, recurrence, metaplasia
- MeSH terms
- Combined Modality Therapy, Endometriosis, Female, Humans, Infertility, Female, Gonadotropin-Releasing Hormone, Metaplasia, Ovarian Cysts, Ovarian Diseases, Pregnancy, Recurrence, Goserelin, Laser Therapy
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