Results of Conservative Surgery for Ovarian Endometriomas in Ramathibodi Hospital

Abstract

Objective to study the outcomes of conservative surgery for ovarian endometriomas, with and without adjunctive medical therapy. Study Design Retrospective descriptive study.

Main Outcome Measures The annual and 3-year cumulative recurrent and pregnancy rates

Results Of 222 patients, 155 had completed 3 years follow-up ( 70 % ). Seventy patients who had conservative surgery alone had 1, 2 and 3 year cumulative recurrent rates of 5.71, 17.14 and 17.14 %, respectively. Eighty five patients who had medical therapy after surgery had 1, 2 and 3 year cumulative recurrent rates of 1.17, 7.06 and 15.29 %, respectively. Among 107 patients who were desirous of pregnancy, 59 patients who had surgery alone had 1, 2 and 3 year cumulative pregnancy rates of 6.78, 18.64 and 20.34 %, respectively, while 48 patients who had medical therapy after surgery had 1, 2 and 3 year cumulative pregnancy rates of 2.08, 8.33 and 16.66 %, respectively. When all 212 patients were analysed using survival analysis, survival probability in the third year were 0.816 and 0.845 in patients who had conservative surgery without and with adjunctive medical therapy, respectively.

Conclusions High recurrence and low pregnancy rates after conservative surgery for ovarian endometriomas were observed irrespective of adjunctive medical therapy. Further randomized controlled trials should be conducted to find the optimum therapeutic regime for these patients.