title: Postoperative oral contraceptive exposure and risk of endometrioma recurrence.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Milan, Milan, Italy. paolo.vercellini@unimi.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Vercellini
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Raffaella
authors.initials: R
authors.lastname: Daguati
authors.forename: Paola
authors.initials: P
authors.lastname: Vigano
authors.forename: Francesca
authors.initials: F
authors.lastname: Meroni
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Crosignani
mesh_terms: 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
chemical_list: D003276:Contraceptives, Oral