Recurrence of endometriosis in women with bilateral adnexectomy (with or without total hysterectomy) who received hormone replacement therapy.
OBJECTIVE
To estimate the risk of recurrence after administration of hormone replacement therapy (HRT) among women who have had endometriosis and who underwent bilateral salpingo-oophorectomy (BSO).


METHODS
Prospective randomized trial (115 women receiving HRT and 57 not receiving HRT). SETTING; Public university hospital.


METHODS
Women with a histologic diagnosis of endometriosis in whom BSO was performed; 91.8% had a total hysterectomy.


METHODS
Periodical clinical examination, vaginal ultrasound, and CA-125 levels; surgical evaluation and histologic study.


METHODS
Recurrence rate, prognostic factors, and a mean follow-up time of 45 months.


RESULTS
There was no recurrence among women who did not receive HRT, versus a 3.5% rate (4 out of 115), or 0.9% per year, in women who received HRT. Two recurrences required abdominal surgery. There was one additional patient who required surgery, but the relationship to the endometriosis recurrence was controversial. Among women receiving HRT, the following risk factors were detected: peritoneal involvement > 3 cm (2.4% recurrence per year vs. 0.3%) and incomplete surgery (22.2% per patient vs. 1.9%).


CONCLUSIONS
Patients with a history of endometriosis in whom total hysterectomy and bilateral salpingo-oophorectomy have been performed have a low risk of recurrence when HRT is administered. In those patients, HRT is a reasonable option. However, in cases with peritoneal involvement > 3 cm, the recurrence rate makes HRT a controversial option; if HRT is indicated, it should be monitored closely.
Matorras
Roberto
R
Department of Obstetrics and Gynecology, Hospital of Cruces, País Vasco University, Baracaldo, Vizcaya, Spain. matorras@hcru.osakidetza.net
Elorriaga
Miguel A
MA
Pijoan
Jose I
JI
Ramón
Olga
O
Rodríguez-Escudero
Francisco J
FJ
D018394:CA-125 Antigen / Q000032:analysis; D004715:Endometriosis / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D010052:Ovariectomy; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
D018394:CA-125 Antigen