Laparoscopic Treatments of Ovarian Endometriomas: Cystectomy Versus Cautrization

Ovarian endometriosis is a condition affecting women in the reproductive age. The correlation between ovarian endometriosis and both infertility and pain is well documented, but several aspects of this disease, including most effective treatment are not well established. So the best management of ovarian endometriosis is controversial. In this study we want to assess the efficacy of two laparoscopic methods for the management of ovarian endometriosis:cystectomy and cauterization, in terms of pain relief, pregnancy rate, and disease recurrence.Subjects and This is a retrospective study which was performed from 2006 to 2009. In this period, 85 patients with ovarian endometrioma operated with laparoscopy, were entered the study. One group underwent cauterization(groupA) and cystectomy was performed for another group (group B). Thirty patients were studied in group A and 55 in group B. Then we compared the recurrence of signs and symptoms of endometrioma, especially pain and pregnancy rate in these two groups. The recurrence of symptoms, especially pelvic pain was 83.3% in group A and 76.4% in group B after 1 year. There was no significant difference statistically. The pregnancy rate was significantly higher in group A (73.3%) than in group B (36.4%) at 1 year follow up (P<0.001). Recurrence rate was lower in group A (23.3%) than in group B (34.5%), but this difference was not significant. Cauterization was a better choice than cystectomy because it lead to higher pregnancy rate, and cystectomy could cause reduced follicular response in controlled ovarian hyper stimulation cycles.