Recurrent ovarian endometrioma after conservative surgery: A retrospective study

Objective: To study the prevalence and associated factors of recurrent ovarian endometrioma after ovarian cystectomy. Methods: This retrospective study analyzed 303 patients who underwent cystectomy for ovarian endometrioma and had at least a 2-year follow-up at Srinagarind Hospital from January 2013 to December 2018. The patients were divided into the recurrent and nonrecurrent groups according to the findings from postoperative transvaginal ultrasonography 6 months after undergoing surgery. Nineteen factors were collected for risk evaluation. The prevalence of recurrent ovarian endometrioma and its 95% confident interval (CI) were calculated. Univariate and multivariable logistic regression analyses were performed to determine the association between factors and recurrence. Results: Recurrent ovarian endometrioma occurred in 33% (95% CI 27.7%-38.3%) patients. The median duration of follow-up was 36 months. during the median follow-up period of 36 months. Preoperative history of parity, preoperative infertility history, endometriosis surgery, moderate to severe dysmenorrhea, dyspareunia, intraoperative stage 4 according to revised American Society for Reproductive Medicine classification, presence of adenomyosis, and postoperative pain relief were associated factors based on univariate analysis. In contrast, infertility [odds ratio (OR) 2.22, 95% CI 1.14-4.33], moderate to severe dysmenorrhea (OR 2.13, 95% CI 1.09-4.15), and postoperative pelvic pain relief (OR 0.22, 95% CI 0.12-0.42) were independently associated factors based on multivariable logistic regression analysis. Conclusions: In our setting, preoperative infertility history and moderate to severe dysmenorrhea were associated with a higher recurrent ovarian endometrioma risk. In contrast, postoperative pain relief was significantly associated with lower recurrence risk.