Ovarian cystectomy versus laser vaporization in the treatment of ovarian endometriomas: a randomized clinical trial with a five-year follow-up

Francisco Carmona, M. Angeles Martìnez-Zamora, Aintzane Rabanal, Sergio Martìnez-Romàn, Juan Balasch

Fertil Steril® Vol. 96, No. 1, July 2011

Objective: To investigate the effect of two laparoscopic techniques for treatment of ovarian endometriomas on recurrence rate.
Design: Prospective randomized clinical trial.
Setting: University teaching hospital.
Patient(s): Ninety women with ovarian endometriomas.
Intervention(s): Patients were randomly selected to undergo either laparoscopic cystectomy (group 1) or laser vaporization (group 2) of ovarian endometrioma.
Main Outcome Measure(s): Recurrence, evaluated by ultrasound scan examination, was assessed at 12 and 60 months of follow-up.
Result(s): Endometrioma recurrence rate was higher, though not significantly different, in group 2 at 60 months of follow-up. Nevertheless, at 12 months of follow-up recurrences were statistically higher in group 2. Conclusion(s): The comparison between laparoscopic laser ablation and laparoscopic cystectomy for ovarian endometriomas after long-term follow-up showed earlier recurrences and a higher recurrence rate in the laser group, although at 5 years of follow-up there were no statistically significant differences. (Fertil Steril® 2011;96:251–4. Copywrigth 2011 by American Society for Reproductive Medicine.)
Key Words: Ovarian endometrioma, laparoscopic surgery, endometriosis, cystectomy, laser vaporization, ovarian reserve, recurrence

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