Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study

Objective: To identify prognostic factors for pain and endometrioma recurrence after complete laparoscopic excision of endometrioma(s). Design: Prospective observational study. Setting: Tertiary care university hospital. Patient(s): One-hundred sixty-six consecutive women affected by uni- or bilateral ovarian endometrioma(s). Intervention(s): Laparoscopic conservative treatment of endometriosis. Main Outcome Measure(s): Patient demographic characteristics, surgical findings, and Surgical results were prospectively recorded. Postoperative follow-ups were carried out every 3 months to identify pain and/or endometrioma recurrence for a Minimum of 3 years. Result(s): Dysmenorrheal, dyspareunia, and chronic pelvic pain recurred in 14.5%, 6%, and 5.4% of women, respectively. Prior surgery for endometriosis, adhesion extension, and use of ovarian Stimulation drugs (OSD) were unfavorable prognostic factors for pain symptoms. Ovarian endometrioma recurred in 9.6% of cases; negative factors were prior surgery for endometriosis. OSD, pelvic adhesions, and high American Society for Reproductive Medicine disease scores. Postoperative pregnancy showed a significant protective effect on pain and disease recurrences. Conclusion(s): Prior surgery, presence of adhesions, and ovulation drugs are negative prognostic factors. Pregnancy has a protective effect on disease and pain recurrence. (Fertil Stefil (R) 20 10;93:716-21. (C)2010 by American Society for Reproductive Medicine.)