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Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):613-618
DOI 10.1590/S0100-72032005001000008
PURPOSE: to evaluate the results of 14 cases of laparoscopic surgical treatment of patients with deep endometriosis of the rectovaginal septum in the Sector of Gynecological Endoscopy of the 'Hospital do Servidor Público Estadual "Francisco Morato de Oliveira"'. METHODS: a retrospective analysis was accomplished with data from the records, associated with postoperative evaluation of the patients operated between February 2002 and February 2004. The patients' age varied from 33 to 44 years, with a mean of 38.4. The parity ranged from 0 to 3, with a mean of 1.1. The main preoperative symptoms were: dysmenorrhea in 14 (100%), deep dyspareunia in 12 (85.7%), non-ciclic pelvic pain in 10 (71.4%), pain at defecation in two (14.3%), rectal bleeding in two (14.3%), and infertility in two (14.3%). The plasma level of CA-125 ranged from 3.6 to 100.3 U/mL, with a mean of 52.9 U/mL. RESULTS: the histological examination of the lesions of the rectovaginal septum was compatible with endometriosis in nine (64.3%) patients. Concerning painful symptoms, there was total regression in seven (50%) patients, partial regression (more than 80% relief) in two (14.3%), no improvement in four (28.6%), and worsening in one (7.1%). The incidence of complications was 14.3%: a ureter lesion associated with lesion of the sigmoid and a lesion of the rectum diagnosed on the 8th postoperative day. Conclusion: it can be concluded that endometriosis of the rectovaginal septum can be treated through laparoscopic surgery with low morbidity, leading to a complete or almost complete relief of the symptoms in most of the patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):613-618
DOI 10.1590/S0100-72032005001000008
PURPOSE: to evaluate the results of 14 cases of laparoscopic surgical treatment of patients with deep endometriosis of the rectovaginal septum in the Sector of Gynecological Endoscopy of the 'Hospital do Servidor Público Estadual "Francisco Morato de Oliveira"'. METHODS: a retrospective analysis was accomplished with data from the records, associated with postoperative evaluation of the patients operated between February 2002 and February 2004. The patients' age varied from 33 to 44 years, with a mean of 38.4. The parity ranged from 0 to 3, with a mean of 1.1. The main preoperative symptoms were: dysmenorrhea in 14 (100%), deep dyspareunia in 12 (85.7%), non-ciclic pelvic pain in 10 (71.4%), pain at defecation in two (14.3%), rectal bleeding in two (14.3%), and infertility in two (14.3%). The plasma level of CA-125 ranged from 3.6 to 100.3 U/mL, with a mean of 52.9 U/mL. RESULTS: the histological examination of the lesions of the rectovaginal septum was compatible with endometriosis in nine (64.3%) patients. Concerning painful symptoms, there was total regression in seven (50%) patients, partial regression (more than 80% relief) in two (14.3%), no improvement in four (28.6%), and worsening in one (7.1%). The incidence of complications was 14.3%: a ureter lesion associated with lesion of the sigmoid and a lesion of the rectum diagnosed on the 8th postoperative day. Conclusion: it can be concluded that endometriosis of the rectovaginal septum can be treated through laparoscopic surgery with low morbidity, leading to a complete or almost complete relief of the symptoms in most of the patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(2):77-81
DOI 10.1590/SO100-720320140005199
To analyze the factors that might influence the recurrence of ovarian endometriomas after laparoscopic excision.
A retrospective cohort study. We evaluated 129 patients who underwent laparoscopic excision of ovarian endometriomas from 2003 to 2012 and who were followed up for at least two years after surgery. Vaginal ultrasound was repeated to exclude persistent lesion and to identify recurrence. The Student's t-test was used to compare continuous variables and the χ or Fischer exact test (for values of less than five) was used to test homogeneity between proportions. A logistic regression model for multivariate proportional hazards was used to analyze predictors of long-term outcome. The level of significance was set at 5% in all analyses.
The overall rate of ovarian endometrioma recurrence was 18.6%. Endometrioma diameter, surgical procedure techniques and demographic data such as age, presenting symptoms, body mass index, smoking and physical exercise habits were not associated with recurrence, whereas interruption of postoperative medical treatment was significantly correlated with a higher recurrence rate (OR 23.7; 95%CI 5.26-107.05; p=0.001).
Current oral contraceptive use appears to be associated with a dramatic reduction in the risk of recurrence of ovarian endometriotic cysts. Treatment interruption was associated with a higher recurrence rate of ovarian endometrioma after laparoscopic treatment.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(2):77-81
DOI 10.1590/SO100-720320140005199
To analyze the factors that might influence the recurrence of ovarian endometriomas after laparoscopic excision.
A retrospective cohort study. We evaluated 129 patients who underwent laparoscopic excision of ovarian endometriomas from 2003 to 2012 and who were followed up for at least two years after surgery. Vaginal ultrasound was repeated to exclude persistent lesion and to identify recurrence. The Student's t-test was used to compare continuous variables and the χ or Fischer exact test (for values of less than five) was used to test homogeneity between proportions. A logistic regression model for multivariate proportional hazards was used to analyze predictors of long-term outcome. The level of significance was set at 5% in all analyses.
The overall rate of ovarian endometrioma recurrence was 18.6%. Endometrioma diameter, surgical procedure techniques and demographic data such as age, presenting symptoms, body mass index, smoking and physical exercise habits were not associated with recurrence, whereas interruption of postoperative medical treatment was significantly correlated with a higher recurrence rate (OR 23.7; 95%CI 5.26-107.05; p=0.001).
Current oral contraceptive use appears to be associated with a dramatic reduction in the risk of recurrence of ovarian endometriotic cysts. Treatment interruption was associated with a higher recurrence rate of ovarian endometrioma after laparoscopic treatment.