López CN, Paz RL, Hernández GA, de Santiago GJ, San José VB

Language: Spanish
References: 10
Page: 753-760
PDF size: 221.66 Kb.

ABSTRACT

Background: Endometriosis affects to 5-12% women. Laparoscopic surgery is the treatment of choice, but the high rate of recurrence is alarming.
Objective: Analyse the influence of various variables in the recurrence after ovarian endometrioma laparoscopic excision.
Material and methods: Retrospective study of 214 cases with laparoscopic treatment in 2005 and 2006 in the Hospital La Paz. A 5 years follow-up was made. Choosen recurrence criteria were pain and suggestive ultrasound finding. Variables studied were: age, pain (0-10), Ca 125 levels, myoma, adenomyosis, number, size and laterality of cyst, medical treatment before and after laparoscopic surgery, infertility, kind of surgery and characteristics, progression and treatment of recurrences.
Results: 30,8% (66/214) of patients presented pain recurrence, 28%(60/214) ultrasound recurrence. Patients with symptomatic recurrence had a bigger degree of dysmenorrhea and dyspareunia before surgery (6.8 ± 2.5 and 1.3 ± 2.5 against 3.8 ± 3.4 and 0.2 ± 1.0 in no recurrence ones (p=0.0001; p=0.0001). Previous dysmenorrheal and dyspareunia punctuation was also greater in ultrasound recurrences (5.9 ± 3.3 and 1.2 ± 2.5 against 4.3 ± 3.4 and 0.2 ± 1.1 of those with no recurrence) (p=0.003; p=0.002). Dysmenorrhea recurrence was greater in young (31.3 ± 5.4 years old versus 34.3 ± 7.8; p=0.02), with cystectomy (35% versus 16,7% in adnexectomy; p=0.02), adhesiolysis (46.4% versus 23.4%; p=0.001) and with medical treatment after surgery (41.5% against 22.5%; p=0.004). The mean time of no symptomatic recurrence was 44 months (CI 95%: 41-47) and the no ultrasound recurrence was 47 months (CI 95%:45-50).
Conclusion: Dysmenorrhea and dyspareunia degree before surgery was the most clearly associated factor with recurrence.

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