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

ABSTRACT

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.