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Risk factors for recurrence and re‐recurrence of ovarian endometriomas after laparoscopic excision
Author(s) -
Hayasaka Shinichi,
Ugajin Tomohisa,
Fujii Osamu,
Nabeshima Hiroshi,
Utsunomiya Hiroki,
Yokomizo Rei,
Yuki Hiromithu,
Terada Yukihiro,
Murakami Takashi,
Yaegashi Nobuo
Publication year - 2011
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2010.01409.x
Subject(s) - medicine , pregnancy , menstruation , endometriosis , laparoscopic surgery , univariate analysis , laparoscopy , surgery , proportional hazards model , risk factor , biochemical recurrence , obstetrics , multivariate analysis , gynecology , cancer , prostatectomy , genetics , biology , prostate
Aim: Since ovarian endometrioma is frequently diagnosed in women of reproductive age, laparoscopic excision of the endometrioma is performed for most cases. However, endometriomas frequently recurs even after repeated surgical procedures. The aim of our study is to identify risk factors for recurrence and re‐recurrence of endometriomas after the first and second laparoscopic excision. Material & Methods: We retrospectively evaluated 173 patients who had a minimum of one year postoperative follow‐up after the laparoscopic excision of endometriomas. Ten and eight factors were evaluated to assess their effect on the risk of recurrence and re‐recurrence, respectively. Factors were analyzed using univariate and the Cox regression test. Results: The overall rate of recurrence and re‐recurrence were 45.1% and 45.5%, respectively. A high revised American Society for Reproductive Medicine score (1997) was associated with an increased risk of recurrence. Only postoperative pregnancy was associated with a decreased risk of recurrence. Short periods of normal menstruation without pregnancy or gonadotrophin‐releasing hormone analogues from first surgery to recurrence were associated with higher rate of re‐recurrence. Conclusions: A high revised American Society for Reproductive Medicine score was a risk factor, and postoperative pregnancy was protective against recurrence. The patient with short periods of normal menstruation without pregnancy or gonadotrophin‐releasing hormone analogues from first surgery to recurrence had a high risk of re‐recurrence.