title: Risk factors for recurrence and re-recurrence of ovarian endometriomas after laparoscopic excision.
abstract: OBJECTIVE
  Since ovarian endometrioma is frequently diagnosed in women of reproductive age, laparoscopic excision of the endometrioma is performed for most cases. However, endometriomas frequently recurs even after repeated surgical procedures. The aim of our study is to identify risk factors for recurrence and re-recurrence of endometriomas after the first and second laparoscopic excision.
  
  
  METHODS
  We retrospectively evaluated 173 patients who had a minimum of one year postoperative follow-up after the laparoscopic excision of endometriomas. Ten and eight factors were evaluated to assess their effect on the risk of recurrence and re-recurrence, respectively. Factors were analyzed using univariate and the Cox regression test.
  
  
  RESULTS
  The overall rate of recurrence and re-recurrence were 45.1% and 45.5%, respectively. A high revised American Society for Reproductive Medicine score (1997) was associated with an increased risk of recurrence. Only postoperative pregnancy was associated with a decreased risk of recurrence. Short periods of normal menstruation without pregnancy or gonadotrophin-releasing hormone analogues from first surgery to recurrence were associated with higher rate of re-recurrence.
  
  
  CONCLUSIONS
  A high revised American Society for Reproductive Medicine score was a risk factor, and postoperative pregnancy was protective against recurrence. The patient with short periods of normal menstruation without pregnancy or gonadotrophin-releasing hormone analogues from first surgery to recurrence had a high risk of re-recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Miyagi, Japan. shinichihayasaka@yahoo.co.jp
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hayasaka
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Ugajin
authors.forename: Osamu
authors.initials: O
authors.lastname: Fujii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nabeshima
authors.forename: Hiroki
authors.initials: H
authors.lastname: Utsunomiya
authors.forename: Rei
authors.initials: R
authors.lastname: Yokomizo
authors.forename: Hiromithu
authors.initials: H
authors.lastname: Yuki
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Terada
authors.forename: Takashi
authors.initials: T
authors.lastname: Murakami
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yaegashi
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000453:epidemiology* / Q000601:surgery*; D010053:Ovary / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors