title: The role of ovarian fossa evaluation in patients with ovarian endometriosis.
abstract: OBJECTIVE
  The aim of this study is to evaluate prospectively the presence of endometriosis in the peritoneum of the ovarian fossa of patients affected by endometriomas and its correlation with the adhesion between this peritoneum and endometrioma.
  
  
  METHODS
  Patients presenting ovarian endometriomas and candidate to laparoscopy were considered for inclusion in the study. Patients underwent laparoscopic excision of endometriomas. The presence of adherence of the ovarian fossa to endometrioma was investigated. In all patients, the removal of a peritoneum fragment from the ovarian fossa of the affected ovary was carried out.
  
  
  RESULTS
  68 patients were enrolled in the study. 48 patients presented adhesions to the ovarian fossa. Histopathologic examination of the peritoneum of the ovarian fossa revealed the presence of endometriosis in 87 % of patients presenting adhesions of the endometriomas with ovarian fossa; surprisingly it was present only in 15 % of patients not presenting this condition (p < 0.0001). Pain symptoms were more frequent in patients with endometriomas adhesion to the ovarian fossa. CA125 levels were not statistically significantly different between groups. At 12-month follow-up, four patients presented endometrioma recurrence. All of them presented adhesion of the ovarian fossa to the endometrioma in the first operation.
  
  
  CONCLUSIONS
  There is a strong association between adhesion of the endometriomas to the ovarian fossa and the presence of endometriosis on the peritoneal surface of the fossa. This condition significantly correlates with pain symptoms and may predict endometrioma recurrence. The removal of this peritoneum in case of adherent endometrioma may potentially reduce the incidence of recurrence.
authors: Department of Obstetrics and Gynecology, "Campus Bio-Medico" University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors: Carlo
authors: C
authors: De Cicco Nardone
authors: Corrado
authors: C
authors: Terranova
authors: Francesco
authors: F
authors: Plotti
authors: Roberto
authors: R
authors: Ricciardi
authors: Stella
authors: S
authors: Capriglione
authors: Daniela
authors: D
authors: Luvero
authors: Donatella
authors: D
authors: Caserta
authors: Massimo
authors: M
authors: Moscarini
authors: Pierluigi
authors: P
authors: Benedetti Panici
authors: Roberto
authors: R
authors: Angioli
mesh_terms: D000293:Adolescent; D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010049:Ovarian Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D010053:Ovary / Q000473:pathology; D010147:Pain Measurement; D010532:Peritoneal Diseases / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D010537:Peritoneum / Q000473:pathology*; D011446:Prospective Studies; D012008:Recurrence; D000267:Tissue Adhesions / Q000473:pathology