Post-operative oral contraceptive use reduces the risk of ovarian endometrioma recurrence after laparoscopic excision
Abstract
BACKGROUND: The aim of this study was to evaluate the impact of post-operative oral contraceptives (OCs) use on the rate of recurrence after laparoscopic excision of ovarian endometrioma. METHODS: In May 2005, we introduced a 'post-operative OC recommendation' for patients treated with laparoscopic excision of endometrioma. That is, at the time of the operation, we provided each patient with information about OC, known and possible benefits and risks and let her decide whether to take OC. A retrospective cohort study included 87 patients who underwent a laparoscopy after May 2005. The endometrioma recurrence rate at 24 months was compared between those who used OC for the entire follow-up period OC (n = 34) and all of the others (n = 53). We also performed logistic regression analysis to identify variables associated with recurrence. A before-after study included another 224 patients who underwent a laparoscopy before May 2005 and compared the recurrence rate before and after introduction of the 'post-operative OC recommendation'. RESULTS: The recurrence rate in those who used OC for the entire period was significantly lower than in the 'others' group (2.9 versus 35.8%, relative risk 0.082, 95% CI 0.012-0.58, P < 0.001). Post-operative OC was determined as an independent variable associated with lower recurrence (OR 0.054, 95% CI 0.007-0.429, P < 0.001). The overall recurrence rate in patients who underwent laparoscopy after the introduction of the 'post-operative OC recommendation' was significantly lower than that in patients who received laparoscopy before the introduction (18.6 versus 33.1%, relative risk 0.56, 95% CI 0.32-0.97, P < 0.05). CONCLUSIONS: Post-operative OC use reduces the risk of ovarian endometrioma recurrence after laparoscopic excision. This information will help in appropriate planning of pre- and post-operative management.
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COCs prevent and reduce the frequency and severity of recurrent dysmenorrhea and relapse of endometriosis after surgery.
“Some studies showed that COCs prevent and reduce frequency and severity of recurrent dysmenorrhea and relapse of endometriosis after surgery [252–256].”
From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [254]
The Retrospective cohort study reports substantially lower ovarian endometrioma recurrence with continuous postoperative OC use. But the Before-after study found no significant reduction in pain recurrence, and the Discussion says pain severity was not assessed quantitatively. This paper therefore does not support the claimed reduction in recurrent dysmenorrhea frequency or severity. (LLM, conf=0.90)
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- Authors
- Takamura, M., Koga, K., Osuga, Y., Takemura, Y., Hamasaki, K., Hirota, Y., Yoshino, O., & Taketani, Y.
- Affiliations
- The University of Tokyo (JP)
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-08-14
- Volume
- 24
- Issue
- 12
- Pages
- 3042-3048
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2135797304
- Cited by
- 98
- References
- 28
- Citations by year
- 2026: 4 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 6 · 2019: 9 · 2018: 4 · 2017: 5 · 2016: 7 · 2015: 11 · 2014: 4 · 2013: 16 · 2012: 9
- FWCI
- 6.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Education, Culture, Sports, Science and Technology
- Ministry of Health, Labour and Welfare
- Japan Society for the Promotion of Science
- 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, oral contraceptives, endometrioma recurrence, laparoscopic resection, postoperative hormonal therapy, recurrence prevention
- MeSH terms
- Adult, Clinical Protocols, Combined Modality Therapy, Contraceptives, Oral, Endometriosis, Female, Humans, Ovarian Diseases, Ovariectomy, Patient Compliance, Laparoscopy, Postoperative Period, Retrospective Studies, Risk, Statistics as Topic, Secondary Prevention
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