IMR Press / FBE / Volume 5 / Issue 2 / DOI: 10.2741/E648

Frontiers in Bioscience-Elite (FBE) is published by IMR Press from Volume 13 Issue 2 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Review

Recurrence of endometrioma after laparoscopic excision and its prevention by medical management

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1 Department of Obstetrics and Gynecology, School of Medicine, University of Tokyo, Japan, 7-3-1 Hongo Bunkyo Tokyo, 113- 8655, Japan

*Author to whom correspondence should be addressed.

Academic Editor: Khaleque Newaz Khan

Front. Biosci. (Elite Ed) 2013, 5(2), 676–683; https://doi.org/10.2741/E648
Published: 1 January 2013
(This article belongs to the Special Issue Frontiers in endometriosis)
Abstract

Laparoscopic excision is considered as the ‘gold standard’ treatment of ovarian endometrioma. However, a frustrating aspect is that disease can recur. While laparoscopic excision is known to improve fertility, recurrence can cause significant ovarian damage and adverse affects on fertility. It is therefore crucial to prevent recurrence in order to conserve ‘improved’ fertility. Recurrence rates for endometrioma are reported from 11 to 32% within 1-5 years after excision. The recurrence rate is higher in patients with advanced endometriosis at surgery and in younger patients. Previous medical treatment for endometriosis prior laparoscopy is a risk factor for recurrence. Pregnancy soon after surgery has a protective effect for recurrence. The accumulating evidence suggests that the administration of oral contraceptives (OC), levonorgestrel-releasing intrauterine system (LNG-IUS) and a combination of gonadotropin releasing hormone (GnRH) analogue and OC may also have therapeutic benefits. Collectively, we propose that women should be well informed about the risks of endometrioma recurrence. We recommend that women who wish pregnancy should try conception as soon as possible. Further, we strongly advise hormonal therapy for patients, who do not want to conceive immediately, and until pregnancy is desired.

Keywords
Endometriosis
Laparoscopy
Recurrence
Oral Contraceptives
Review
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