Large ovarian endometriomas.
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.
Donnez
J
J
Department of Gynecology, Catholic University of Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
Nisolle
M
M
Gillet
N
N
Smets
M
M
Bassil
S
S
Casanas-Roux
F
F
D003131:Combined Modality Therapy; D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D017273:Goserelin / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D053685:Laser Therapy; D008679:Metaplasia; D010048:Ovarian Cysts / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D010049:Ovarian Diseases / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D012008:Recurrence
D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone