title: A prospective, randomized study comparing laparoscopic ovarian cystectomy versus fenestration and coagulation in patients with endometriomas.
abstract: OBJECTIVE
  To determine the difference between two laparoscopic methods for the management of endometriomas with regard to recurrence of signs and symptoms and pregnancy rate.
  
  
  METHODS
  Prospective, randomized clinical trial.
  
  
  METHODS
  Infertility and gynecologic endoscopy units of two medical university hospitals.
  
  
  METHODS
  One hundred patients with endometriomas who had either infertility or pelvic pain.
  
  
  METHODS
  Patients were randomly divided into two groups; one group underwent cystectomy (group 1), and fenestration and coagulation were performed for the other (group 2).
  
  
  METHODS
  A comparison of recurrence of signs and symptoms of endometriomas and pregnancy rates in two groups.
  
  
  RESULTS
  Fifty-two patients were studied in group 1 and 48 in group 2. The recurrence of symptoms, such as pelvic pain and dysmenorrhea, was 15.8% in group 1 and 56.7% in group 2 after 2 years. The rate of reoperation was 5.8% in group 1 and 22.9% in group 2 and these differences were statistically significant. The cumulative pregnancy rate was significantly higher in group 1 (59.4%) than in group 2 (23.3%) at 1-year follow-up.
  
  
  CONCLUSIONS
  Laparoscopic cystectomy of endometriomas is a better choice than fenestration and coagulation because the former technique leads to a lower recurrence of signs and symptoms and a lower rate of reoperation and a higher cumulative pregnancy rate than the latter.
authors.affiliation: Division of Infertility and Endoscopy, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. alborzis@sums.ac.ir
authors.forename: Saeed
authors.initials: S
authors.lastname: Alborzi
authors.forename: Mozhdeh
authors.initials: M
authors.lastname: Momtahan
authors.forename: Mohammad Ebrahim
authors.initials: ME
authors.lastname: Parsanezhad
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Dehbashi
authors.forename: Jaleh
authors.initials: J
authors.lastname: Zolghadri
authors.forename: Soroosh
authors.initials: S
authors.lastname: Alborzi
mesh_terms: D000328:Adult; D015653:Cystectomy; D004412:Dysmenorrhea / Q000209:etiology; D004715:Endometriosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D010535:Laparoscopy; D017699:Pelvic Pain / Q000209:etiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome