title: Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study.
abstract: 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.
authors.affiliation: Department of Gynecology and Obstetrics, University of Rome Sapienza, Viale Regina Elena, 324-00161 Rome, Italy. mgporpor@tin.it
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Porpora
authors.forename: Debora
authors.initials: D
authors.lastname: Pallante
authors.forename: Annamaria
authors.initials: A
authors.lastname: Ferro
authors.forename: Brenda
authors.initials: B
authors.lastname: Crisafi
authors.forename: Filippo
authors.initials: F
authors.lastname: Bellati
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Benedetti Panici
mesh_terms: 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