† These authors contributed equally.
Background: The aim of this study was to confirm and analyze
the correlative factors that could influence
the recurrence of ovarian endometriosis after
conservative surgery, including both risk and protective factors.
Methods: From January 2010 to January 2018, a retrospective study was
conducted which included 1080 patients with ovarian endometriosis who received a
minimum of 2 years of follow-up after conservative surgery at a university-based
tertiary care hospital. Recurrence was defined as the presence of ovarian cysts
larger than 2 cm detected by ultrasonography within 2 years after surgery. The
effects of twenty correlative variables on recurrence were evaluated.
Results: The cumulative 2-year recurrence rate of ovarian endometriosis
after conservative surgery was 15%. According to the logistic regression
analysis, the significant risk factors that were independently associated with
high recurrence of endometriosis were previous medical treatment of endometriosis
(odds ratio [OR] = 2.06; 95% confidence interval [95% CI] = 1.27–3.34;
P = 0.004), painful nodules in the pouch of Douglas (OR = 2.44; 95% CI
= 1.23–4.85; P = 0.011), largest cyst diameter (OR = 1.54; 95% CI =
1.08–2.18; P = 0.016) and bilateral ovarian involvement (OR = 1.69;
95% CI = 1.19–2.39; P = 0.003). Moreover, the protective factors that
were independently associated with low recurrence of endometriosis were
postoperative medical treatment (OR = 0.59; 95% CI = 0.42–0.84; P =
0.003) and postoperative pregnancy (OR = 0.34; 95% CI = 0.19–0.62;