Postoperative oral contraceptive exposure and risk of endometrioma recurrence.
OBJECTIVE
The purpose of this study was to compare the postoperative risk of endometrioma recurrence in women using oral contraception and in those undergoing simple observation.


METHODS
After laparoscopic excision of ovarian endometriotiomas, a cyclic, low-dose, monophasic oral contraceptive pill (OCP) was offered to women not seeking pregnancy. One month after surgery, and every 6 months afterward, the patients underwent clinical and ultrasonographic assessment.


RESULTS
Of the 277 patients who entered the study, 102 used OCP for the entire follow-up period (always users), 129 used OCP discontinuously (ever users), and 46 declined treatment (never users). The median follow-up was 28 months. Recurrent endometriotic cysts were detected in 74 subjects (27%). The 36-month cumulative proportion of subjects free from endometrioma recurrence was 94% in the always users compared with 51% in the never users (P < .001); adjusted incidence rate ratio (IRR) = 0.10 (95% CI, 0.04-0.24).


CONCLUSIONS
Regular postoperative use of OCP effectively prevents endometrioma recurrence.
Vercellini
Paolo
P
Department of Obstetrics and Gynecology, University of Milan, Milan, Italy. paolo.vercellini@unimi.it
Somigliana
Edgardo
E
Daguati
Raffaella
R
Vigano
Paola
P
Meroni
Francesca
F
Crosignani
Pier Giorgio
PG
D000328:Adult; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D016015:Logistic Models; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D011184:Postoperative Period; D016016:Proportional Hazards Models; D012008:Recurrence; D014463:Ultrasonography
D003276:Contraceptives, Oral