Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study.
OBJECTIVE
To identify prognostic factors for pain and endometrioma recurrence after complete laparoscopic excision of endometrioma(s).


METHODS
Prospective observational study.


METHODS
Tertiary care university hospital.


METHODS
One-hundred sixty-six consecutive women affected by uni- or bilateral ovarian endometrioma(s).


METHODS
Laparoscopic conservative treatment of endometriosis.


METHODS
Patient demographic characteristics, surgical findings, and surgical results were prospectively recorded. Postoperative follow-ups were carried out every 3 months to identify pain and/or endometrioma recurrence for a minimum of 3 years.


RESULTS
Dysmenorrheal, dyspareunia, and chronic pelvic pain recurred in 14.5%, 6%, and 5.4% of women, respectively. Prior surgery for endometriosis, adhesion extension, and use of ovarian stimulation drugs (OSD) were unfavorable prognostic factors for pain symptoms. Ovarian endometrioma recurred in 9.6% of cases; negative factors were prior surgery for endometriosis, OSD, pelvic adhesions, and high American Society for Reproductive Medicine disease scores. Postoperative pregnancy showed a significant protective effect on pain and disease recurrences.


CONCLUSIONS
Prior surgery, presence of adhesions, and ovulation drugs are negative prognostic factors. Pregnancy has a protective effect on disease and pain recurrence.
Porpora
Maria Grazia
MG
Department of Gynecology and Obstetrics, University of Rome Sapienza, Viale Regina Elena, 324-00161 Rome, Italy. mgporpor@tin.it
Pallante
Debora
D
Ferro
Annamaria
A
Crisafi
Brenda
B
Bellati
Filippo
F
Benedetti Panici
Pierluigi
P
D000328:Adult; D004412:Dysmenorrhea / Q000453:epidemiology / Q000601:surgery; D004414:Dyspareunia / Q000453:epidemiology / Q000601:surgery; D004715:Endometriosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D010049:Ovarian Diseases / Q000453:epidemiology / Q000601:surgery; D010062:Ovulation Induction / Q000009:adverse effects; D010149:Postoperative Pain / Q000453:epidemiology*; D017699:Pelvic Pain / Q000453:epidemiology* / Q000601:surgery*; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D000267:Tissue Adhesions / Q000453:epidemiology