Prevention of recurrence after surgery

Abstract

Recurrence of ovarian endometrioma after excision imposes profound encumbrance on the suffered women, with increasing pain, subfertility/infertility, and a risk of ovarian cancer. Postoperative recurrence is relatively common, the rate ranging from 11 to 32 % in 1-5 years. To date, a number of risk factors for the recurrence have been reported, i.e., younger age, larger cysts, high rASRM scores, previous medical treatment, previous surgery for endometriosis, and short-term postoperative medical treatment. In contrast, postoperative pregnancy reduces the risk. Several biomarkers are suggested to predict the recurrence but not yet validated in clinical practice. Postoperative OC use for a long period has been demonstrated to reduce the recurrence remarkably. Postoperative GnRH analogue use is also effective for the reduction of the recurrence. There still remain some issues on the duration and the drugs most suitable for the prevention.