Results of laparoscopic treatments of ovarian endometriomas: laparoscopic ovarian fenestration and coagulation.
OBJECTIVE
To determine the long-term results of laparoscopic fenestration and coagulation of ovarian endometriomas and to compare them with the results of ovarian cystectomy performed by either laparotomy or laparoscopy.


METHODS
Case-control study.


METHODS
Two university-affiliated hospitals.


METHODS
One hundred fifty-six premenopausal women with ovarian endometriomas of at least 3 cm in diameter (stage 3 and 4 endometriosis, revised American Fertility Society classification).


METHODS
Laparoscopic ovarian fenestration and coagulation (group 1, 80 patients); laparoscopic ovarian cystectomy (group 2, 23 patients); and ovarian cystectomy by laparotomy and microsurgical technique (group 3, 53 patients).


METHODS
Operative findings, recurrence rate, and cumulative clinical pregnancy rate (PR) over a 36-month follow-up period.


RESULTS
The mean (+/-SD) time to first pregnancy was significantly shorter in group 1 (1.4+/-0.2 years) than in group 2 (2.2+/-0.5 years) or group 3 (2.4+/-0.5 years). The difference between the cumulative clinical PR between the three groups was not statistically significant after 36 months of follow-up. The difference in the recurrence rate among groups 1, 2, and 3 was not statistically significant.


CONCLUSIONS
Laparoscopic ovarian fenestration and coagulation of endometriomas leads to faster conception than ovarian cystectomy by laparotomy. Laparoscopic ovarian fenestration and coagulation of endometriomas is associated with cumulative clinical PRs and recurrence rates over 36 months that are similar to those associated with ovarian cystectomy.
Hemmings
R
R
McGill University and Centre Hospitalier de l'Université de Montréal, Quebec, Canada.
Bissonnette
F
F
Bouzayen
R
R
D000328:Adult; D016022:Case-Control Studies; D004564:Electrocoagulation; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D010048:Ovarian Cysts / Q000601:surgery*; D011247:Pregnancy; D012008:Recurrence