Ultrasonographic Evaluation of Postoperative Ovarian Cyst Formation after Laparoscopic Excision of Endometriomas

Abstract

Study Objective

To evaluate, by means of serial transvaginal ultrasound (US) examinations, the ovary after laparoscopic excision of endometriomas with the stripping technique.

Design

Prospective, controlled, single-blind clinical trial (Canadian Task Force classification II-1).

Setting

Tertiary care university hospital.

Patients

Forty-seven patients, from 21- to 35-years old, undergoing laparoscopic excision of a monolateral ovarian endometrioma.

Intervention

The patients underwent serial US scans performed by a blinded observer during the first, third, and sixth menstrual cycle after surgery.

Measurements and Main Results

At the first follow-up US examination, an abnormal finding, namely the presence of an ovarian cyst on the operated ovary, was diagnosed in five of 47 patients (10.6%; p = .03 when compared with the nonoperated ovary). In the remaining 42 patients (89.4%), no gross abnormalities were evident. No differences were present between the two ovaries as to ovarian volume or follicular development pattern. During the third follow-up US, in 47 patients (100%) no gross abnormalities were present.

Conclusion

The US follow-up of ovaries operated on for endometriomas by laparoscopy demonstrates that the evidence of an ovarian cyst in the early postoperative period is not an uncommon event. This finding, occurring in approximately 10% of cases, seems to be a transient one occurring during ovarian healing after surgery, since no evidence of such anomaly was present on subsequent US scans. Therefore, treatment for US evidence of recurrence of an ovarian endometrioma should be deferred for at least 3 to 6 months if the diagnosis of recurrence is made in the early postoperative period. Apart from this finding, the operated ovary is indistinguishable from the contralateral one, even 1 month after surgery.