In a nutshell
This paper compared ovarian stripping and cystectomy with regards to recurrence (return) of endometriosis and pregnancy.
Some background
Ovarian endometriomas occurs when endometrium tissue (tissue that lines the uterus) grows inside the ovary, away from its normal location. These endometriomas frequently require surgical removal, usually through laparoscopy (surgery which makes a small incision). There are various types of surgical techniques available to remove the ovarian endometrioma. These techniques include ovarian stripping (the endometrioma is stripped away from the normal ovarian tissue) and cystectomy (removal of cyst, a sac-like structure filled with cells, such as endometrioma).
Methods & findings
109 patients with ovarian endometrioma were studied. Laparoscopic removal of ovarian endometrioma was performed; 45 patients underwent direct ovarian stripping while 64 patients underwent ovarian cystectomy. Patients were followed-up for 2 years.
15.4% of patients treated with cystectomy compared with 55.6% of patients treated with stripping had a recurrence of endometrioma detected by ultrasound. The average time of relapse (worsening of condition and symptoms) was 18 months in patients treated with cystectomy and 17.6 months in patients treated with ovarian stripping. Cancer antigen 125 (protein that is present in high levels in ovarian cancer) levels decreased 12 months after surgery in both groups of patients.
Spontaneous pregnancy rate was 22.3% in patients who underwent cystectomy and 4.4% among patients treated with ovarian stripping. The percentage of patients with healthy ovarian tissue nearby was 26.6% in patients treated with stripping compared with 50% in patients who underwent cystectomy.
The bottom line
The authors concluded that cystectomy is the most appropriate treatment of ovarian endometrioma with regards to recurrence and pregnancy rates.
The fine print
Outcomes of surgery also greatly dependent on many other factors, and vary from individual to individual.
What’s next?
Talk to your doctor about the possibility of undergoing cystectomy for removal of ovarian endometriomas.
Published By :
Archives of Gynecology and Obstetrics
Date :
Feb 01, 2014
