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Hum. Reprod. Advance Access published online on February 26, 2009
Human Reproduction, doi:10.1093/humrep/dep043
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Analysis of risk factors for the removal of normal ovarian tissue during laparoscopic cystectomy for ovarian endometriosis{dagger}

Sachiko Matsuzaki1,3, Céline Houlle1, Claude Darcha2, Jean-Luc Pouly1, Gérard Mage1 and Michel Canis1

1 CHU Clermont-Ferrand, Polyclinique-Hôtel-Dieu, Gynécologie Obstétrique et Médecine de la Reproduction, Boulevard Léon Malfreyt, 63058 Clermont-Ferrand, France 2 CHU Clermont-Ferrand, Hôtel-Dieu, Service d'Anatomie et Cytologie Pathologiques, Clermont-Ferrand, France

3 Correspondence address. Fax: +33-4-73-93-17-06; E-mail: sachikoma{at}aol.com

BACKGROUND: The aim of this study was to identify risk factors for the removal of normal ovarian tissue during laparoscopic cystectomy for endometriosis.

METHODS: A total of 121 patients who had histologically confirmed ovarian endometriosis and 56 control patients who had other histologically confirmed benign cysts were included for the present analysis. The blocks of removed tissue were sectioned at 120 µm intervals and a total of five sections were analyzed for each ovarian cyst. Eight variables (age, pre-operative medical treatment, previous surgery for ovarian endometriosis, single or multiple cysts, size of the largest cyst, side of cyst, co-existence of deep endometriosis, revised American Society for Reproductive Medicine classification) were evaluated using a generalized linear modeling analysis to identify major factors associated with the removal of normal ovarian tissue.

RESULTS: Normal ovarian tissue adjacent to the cyst wall was detected in 71 patients (58.7%) with endometriosis, whereas normal ovarian tissue was removed from only three patients (5.4%) with other benign cysts. A significant factor that was independently associated with the removal of normal ovarian tissue with ovarian endometriosis was pre-operative medical treatment.

CONCLUSIONS: The present retrospective, controlled study suggests that pre-operative medical treatment might be a risk factor for the removal of normal ovarian tissue during laparoscopic cystectomy for ovarian endometriosis.

Key words: ovarian endometriomas/laparoscopic cystectomy/ovarian tissue/pre-operative hormonal treatment/risk factors

{dagger} Presented in part at the 63th Annual Meeting of the American Society for Reproductive Medicine, San Francisco, CA, 8–12 November 2008

Submitted on September 24, 2008; resubmitted on January 27, 2009; accepted on January 29, 2009.


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