A review article on ovarian cystectomy in endometriomas by laparoscopy

Abstract

Endometrioma is one of the most frequent adnexal masses in the reproductive population. Medical therapy is inefficient and cannot be recommended in the management of ovarian endometriomas. The general consensus is that ovarian endometriomas larger than 4 cm should be removed, both to reduce pain and to improve spontaneous conception rates. The removal of ovarian endometriomas can be difficult, as the capsule is often densely adherent. While the surgical treatment of choice is surgical laparoscopy, for conservative treatment, the preferred method is modified combined cystectomy. Cystectomy can be destructive for the ovary, whereas ablation may be incomplete, with a greater risk of recurrence.

Effects of Combined Laparoscopic Cystectomy and Leuprolide Acetate Therapy on Anti-Mullerian Hormone Level and Antral Follicle Count Profile in Endometriosis

“…Though there were several studies stating that there was no indication or benefit in systemic medical therapy, both pre-or post-operative ones, our findings seem to disagree. 10,11 Our research findings seem to be more in line with ones by Tsolakidis et al who found that leuprolide acetate injection, when given as part of 'three-step procedure', might increase AFC at six months postoperative. 12 Various articles have stated that laparoscopic cystectomy procedure itself may cause damage to ovarian tissue which negatively impacts ovarian reserve.…”