title: Recurrence of ovarian endometrioma after laparoscopic excision.
abstract: BACKGROUND
  To analyse risk factors that influence the recurrence of endometrioma after laparoscopic excision.
  
  
  METHODS
  A total of 224 patients who had a minimum of 2 years of post-operative follow-up after laparoscopic ovarian endometrioma excision were studied retrospectively. Recurrence was defined as the presence of endometrioma more than 2 cm in size, detected by ultrasonography within 2 years of surgery. Fourteen variables (age, presence of infertility, pain, uterine myoma, adenomyosis, previous medical treatment of endometriosis, previous surgery for ovarian endometriosis, single or multiple cysts, the size of the largest cyst at laparoscopy, unilateral or bilateral involvement, co-existence of deep endometriosis, revised American Society for Reproductive Medicine (ASRM) score, post-operative medical treatment and post-operative pregnancy) were evaluated to assess their independent effects on the recurrence using logistic regression analysis.
  
  
  RESULTS
  The overall rate of recurrence was 30.4% (68/224). Significant factors that were independently associated with higher recurrence were previous medical treatment of endometriosis [odds ratio (OR) = 2.324, 95% confidence interval (95% CI) = 1.232-4.383, P = 0.0092) and larger diameter of the largest cyst (OR = 1.182, 95% CI = 1.004-1.391, P = 0.0442). Post-operative pregnancy was associated with lower recurrence (OR = 0.292, 95% CI = 0.028-0.317, P = 0.0181).
  
  
  CONCLUSIONS
  Previous medical treatment of endometriosis or large cyst size was a significant factor that was associated with higher recurrence of the disease. Post-operative pregnancy is a favourable prognostic factor.
authors.affiliation: Department of Obstetrics and Gynecology, University of Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Koga
authors.forename: Y
authors.initials: Y
authors.lastname: Takemura
authors.forename: Y
authors.initials: Y
authors.lastname: Osuga
authors.forename: O
authors.initials: O
authors.lastname: Yoshino
authors.forename: Y
authors.initials: Y
authors.lastname: Hirota
authors.forename: T
authors.initials: T
authors.lastname: Hirata
authors.forename: C
authors.initials: C
authors.lastname: Morimoto
authors.forename: M
authors.initials: M
authors.lastname: Harada
authors.forename: T
authors.initials: T
authors.lastname: Yano
authors.forename: Y
authors.initials: Y
authors.lastname: Taketani
mesh_terms: D000328:Adult; D003613:Danazol / Q000627:therapeutic use; D004715:Endometriosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D011247:Pregnancy; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007987:Gonadotropin-Releasing Hormone; D003613:Danazol