Repetitive conservative surgery for recurrence of endometriosis.
We evaluated the recovery of fertility and the relief of pain symptoms in a long-term follow-up of 42 women undergoing repetitive conservative surgery for recurrent endometriosis. The mean age of the patients was 31.1 +/- 4.3 years. At the time of their second operation the disease was stage IV in 14 women, stage III in 25, and stage I in three. After reoperation, the patients were followed for a mean period of 41.8 +/- 30.3 months. Pain symptoms returned in eight women, dysmenorrhea and deep dyspareunia in eight, and pelvic pain in seven. Eight of the 28 women (28.6%) who attempted to conceive achieved a total of 13 pregnancies. The corrected pregnancy rate was 35%, and the cumulative rate at 27 months was 30.7%. A third operation was necessary in six women after a mean period of 35 months. Conservative surgery is an effective therapeutic option for infertile patients with recurrent endometriosis.
Candiani
G B
GB
First Department of Obstetrics and Gynecology, University of Milan, Italy.
Fedele
L
L
Vercellini
P
P
Bianchi
S
S
Di Nola
G
G
D000328:Adult; D004412:Dysmenorrhea / Q000209:etiology; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000150:complications / Q000601:surgery*; D010146:Pain / Q000209:etiology; D011247:Pregnancy / Q000706:statistics & numerical data; D011446:Prospective Studies; D012086:Reoperation; D013514:Surgical Procedures, Operative / Q000379:methods; D014594:Uterine Neoplasms / Q000150:complications / Q000601:surgery*