Large ovarian endometriomas

Donnez, Jacques; Nisolle, Michelle; Gillet, Nadine; Smets, Mireille; Bassil, S.; Casanas-Roux, Franco̧ise

doi:10.1093/humrep/11.3.641

Cited by 333 publications

(255 citation statements)

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“…The American College of Obstetricians and Gynecologists Practice Bulletin suggests that the true recurrence rate must be even higher than the rate generally reported in literature, because most publications report symptomatic disease only [11]. Conservative laparoscopic surgery is considered to be the gold standard for the treatment of ovarian endometriosis [12][13][14][15][16][17]. There is general agreement that endometrioma removal increases the likelihood of conception [18,19], and recent evidence shows that both the presence of an endometrioma and its surgical excision may impair ovarian reserve and, therefore, future fertility [20,21], especially after a second operation.…”

Section: Introductionmentioning

confidence: 99%

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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Objective The primary aim of the study was to analyze the endometrioma recurrence rate in patients who underwent laparoscopic excision followed by postoperative longterm regimen of oral contraceptives (OCs). Materials and methods 168 patients who underwent a conservative laparoscopic surgery for endometrioma, during the period between September 2009 and August 2010 in three university hospitals were studied. A long-term OCs therapy was offered to all women following surgery. Patients were randomly divided into three groups according to different progestins used (desogestrel, gestodene, dienogest). Women who refused a postoperative hormonal therapy served as control. Follow-up visits and transvaginal scan were planned at 1, 3, 6, 12, and 24 months after surgery. All patients who showed an ultrasound persistence of the endometrioma at 1 month follow-up were excluded from clinical analysis.Results Of the 168 patients, 131 completed the 24 months follow-up. Endometrioma recurrence was found in 21 (12.5 %) of all patients, it was unilateral in 17 cases while bilateral in 4 cases. The rate of recurrent endometrioma was statistically significant in non-users compared to the long-term OCs treated patients. Conclusion The current data suggest the usefulness of long-term OCs regimen after conservative surgery for the prevention of ovarian endometrioma recurrence. As a statistical significant difference could not be observed between OCs groups, further study on the individual molecules is required in order to really understand the effect of each of them.

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Section: Introductionmentioning

confidence: 99%

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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“…The first point can be resolved for our cohort for many reasons, the first reason is that all the patients are below 40 years, with negative family and personal history of malignancies, another point is that the duration between the surgery and the recurrence was more than 2 years which is long period for malignancy, plus the rate of growth before enrollment in the study and ultrasound features all were typical for endometrioma, and all the mentioned parameters should be considered in making the decision for endometrioma management [16]. Regarding the cysts size, definitely the cyst size play role in making the decision, and we can find clear decision for cysts larger than 10 cm to go for surgery, even in the presence of typical ultrasound features [17], and this due to higher possibility of having unexpected non benign growth [18]. Smaller than this size will be evaluated as a factor among several factors, and in our study the maximum size was 7 cm, and the mean was 5.46 cm, and many studies and trials had enrolled patients with same size [10].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Endometrioma; Outcome of Medical Management with Dienogest

Aizzi¹

2017

Eur J Exp Bio

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“…Donnez i wsp. w przypadku torbieli o średnicy powyżej 3 cm stosują technikę trójstopniową, opisaną po raz pierwszy w 1996 r. [27]. W pierwszym etapie wykonują jedynie drenaż torbieli oraz biopsję, a następnie wdrażają 12-tygodniową terapię analogami gonadoliberyny (gonadotropin-releasing hormone -GnRH).…”

Section: -Badania Retrospektywne; Afc -Liczba Pęcherzyków Antralnych unclassified

Principles of removal of endometrial ovarian cysts with particular reference to ovarian reserve

Owczarek¹,

Malinowski²

2012

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StreszczenieEndometrioza, definiowana jako pozamaciczne występowanie komórek gruczołowych i podścieliska błony śluzowej macicy, nadal stanowi wielkie wyzwanie dla lekarzy ginekologów, zwłaszcza w zakresie płodności oraz dolegliwości bólowych. Częstym miejscem występowania endometriozy jest jajnik. Analizując ryzyko nawrotu torbieli, ryzyko nawrotu dolegliwości bólowych oraz współczynnik zajścia w ciążę, można uznać, że laparoskopia jest metodą z wyboru w leczeniu operacyjnym torbieli endometrialnych, wypierając tym samym klasyczną laparotomię. W wielu pracach zostały opisane różne techniki leczenia endoskopowego endometriozy jajnika, ale wydaje się, że standardem w leczeniu operacyjnym powinno być wyłuszczenie pseudotorebki. Każda operacja przeprowadzona z powodu torbieli endometrialnej pociąga za sobą ryzyko jatrogennego uszkodzenia jajnika, a tym samym -zmniejszenie rezerwy jajnikowej. Według danych klinicznych obecnie najlepszymi metodami oceny rezerwy jajnikowej są: liczba pęcherzyków antralnych (antral follicle count -AFC) oraz stężenie hormonu antymüllerowskiego (anti-müllerian hormone -AMH) w surowicy. Stężenie AMH silnie koreluje z AFC widocznych w badaniu ultrasonograficznym (USG). Mniejszą wartość diagnostyczną w ocenie rezerwy jajnikowej ma oznaczenie stężeń folikulotropiny (follicle-stimulating hormone -FSH), luteiny (luteinizing hormone -LH), estradiolu (E 2 ) oraz inhibiny w surowicy. Potrzeba dalszych badań oceniających wpływ energii elektrycznej i szycia jajnika jako metod uzyskania hemostazy na rezerwę jajnikową.Słowa kluczowe: endometrioza, torbiele, rezerwa jajnikowa. SummaryEndometriosis is defined as extra-uterine occurrence of endometrial glandular cells and endometrial stroma, and still represents a great challenge to gynecologists, especially in respect to fertility and pain. Endometriosis often occurs in ovaries. If you analyze the risk of cystic recurrence, the risk of pain recurrence and the pregnancy rate, you may consider that the laparoscopy is the method of choice in surgical treatment of endometrial cysts; correspondingly, it replaces the classical laparotomy. Many studies have described various techniques of endoscopic treatment of ovarian endometriosis, but it seems that the pseudocapsular enucleation should be the standard in surgical treatment. Every surgery carried out due to an endometrial cyst implies a risk of iatrogenic ovarian damage and, by the same token, a reduction in ovarian reserve. According to the newest clinical data, the best methods of assessing the ovarian reserve are: Antral Follicle Count (AFC) and serum concentration of Anti-Müllerian hormone (AMH). Concentration of AMH is highly correlated with the antral follicle count visible in the ultrasound examination. The evaluation of the serum concentration of FSH, LH, E2 and inhibin have a lower diagnostic value in the assessment of ovarian reserve. Further investigations are necessary to assess the impact of electric energy and of ovarian suture -as methods of achieving hemostasis -on the ovarian reserve.

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Large ovarian endometriomas

Cited by 333 publications

References 0 publications

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Recurrent Endometrioma; Outcome of Medical Management with Dienogest

Principles of removal of endometrial ovarian cysts with particular reference to ovarian reserve

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