A prospective, randomized study comparing laparoscopic ovarian cystectomy versus fenestration and coagulation in patients with endometriomas.
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.
Alborzi
Saeed
S
Division of Infertility and Endoscopy, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. alborzis@sums.ac.ir
Momtahan
Mozhdeh
M
Parsanezhad
Mohammad Ebrahim
ME
Dehbashi
Sedigheh
S
Zolghadri
Jaleh
J
Alborzi
Soroosh
S
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