Ovarian endometriosis: what are the risk factors for postop recurrence?

  • Li XY & al.
  • J Ovarian Res

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.


  • Dysmenorrhoea severity and postoperative pregnancy are independent risk factors for the recurrence of endometrioma and endometriosis-related pain recurrence after surgery.

Why this matters

  • Endometrioma recurrence is one of the most important issues in the management of endometriosis.
  • Findings highlight that more attention should be paid to the risk for endometrioma and endometriosis-related pain in patients who have serious dysmenorrhoea and individualised management should be applied to achieve better efficacy.

Study design

  • Retrospective study of 358 women (mean age, 33.2±5.4 years; body mass index (BMI): 21.2±2.6 kg/m2) with endometriomas who had minimum of 5 years of postoperative follow-up after undergoing laparoscopic cystectomy during 2009-2013 was conducted.
  • All women were categorised into recurrence group and non-recurrence group.
  • Funding: National Key R&D Program of China and others.

Key results

  • Cumulative incidence rates of recurrence at 5-10 years after surgery were 15.4%, 16.8%, 19.3%, 22.5%, 22.5% and 22.5%, respectively.
  • Differences were found between 2 groups in terms of:
    • age at surgery (risk ratio [RR], 0.764; 95% CI, 0.615-0.949; P=.015),
    • duration of dysmenorrhoea (RR, 1.120; 95% CI, 1.054-1.190; P<.001>
    • the presence of adenomyosis (RR, 1.629; 95% CI, 1.008-2.630; P=.046) and
    • CA125 level (RR, 1.856; 95% CI, 1.072-3.214; P=.021).
  • In multivariate analysis, extent of dysmenorrhoea (RR, 1.711; 95% CI, 1.175-2.493; P=.005) and postoperative pregnancy (RR, 0.649; 95% CI, 0.460-0.914; P=.013) significantly correlated with endometrioma and endometriosis-related pain recurrence.
  • Gravida, parity, BMI, infertility, leiomyoma presence, size of ovarian endometrioma, the presence of deep infiltrating endometriosis and disease stage or postoperative medication showed no significant association with recurrence rate.


  • Retrospective design.
  • Single-centre study.