Recurrence of ovarian endometrioma after laparoscopic excision

Abstract

Previous medical treatment of endometriosis or large cyst size was a significant factor that was associated with higher recurrence of the disease. Post-operative pregnancy is a favourable prognostic factor.

The effect of the hormonal milieu of pregnancy on deep infiltrating endometriosis: serial ultrasound assessment of changes in size and pattern of deep endometriotic lesions

“…The present report confirmed the beneficial role of pregnancy on endometriosis-related symptomatology already reported by others [18][19][20]. Some evidence suggests that early pregnancy may be prophylactic against the development of endometriosis and could actually cause regression of established lesions.…”

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

“…The study established that 6-month OCs therapy after surgery tends to prevent recurrence at 12 months after surgery, but does not significantly influence recurrence of the disease at 24-and 36-month followup [36]. In yet another study, it was found that mean postoperative treatment of *9 months did not significantly influence recurrence; however, the authors suggested that a longer period of treatment may have an effect on its prevention [6]. Other authors have pointed out that long-term cyclic and continuous OCs use effectively reduces and delays recurrence [2,10].…”

“…''Unfortunately, there is no permanent cure for this condition, so it often requires a life-long management plan with the goal of maximizing the use of medical treatment and avoiding repeated surgical procedures'', reports the American Society of Reproductive Medicine [3]. Lesions and symptoms very frequently return after medication is discontinued or after conservative surgery is performed, a fact which frustrates both patients and clinicians [4] and is estimated to occur in 30-50 % of cases within 2-5 years [2,[5][6][7][8][9][10]. 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].…”

Long-term follow-up after laparoscopic treatment for endometriosis: multivariate analysis of predictive factors for recurrence of endometriotic lesions and pain

“…The benefits of pregnancy on endometriosis' progression and recurrence were also confirmed. Some evidence suggested that early pregnancy may be prophylactic against the development of endometriosis and could actually cause the regression of established lesions [5,7,21]. The mechanisms postulated include production of anovulation and amenorrhea, decidual change and eventual necrosis induced within the lesions.…”