Endometriomas and the Severity of Endometriosis

Sep 6, 2024
Endometriomas and the Severity of Endometriosis

Association Between Ovarian Endometriomas and Endometriosis Stage

Key Points

Highlight:

  • This study underscores the strong association between endometriomas and advanced stages of endometriosis, highlighting how pre-operative detection can refine surgical planning.
Importance:
  • Pre-operative imaging for endometrioma improves surgical planning, patient counseling, and managing endometriosis, particularly in terms of fertility concerns.

What’s done here:

  • A retrospective chart review of 222 patients who underwent endometriosis surgery between 2016 and 2021 was conducted. 
  • The study compared pre-operative imaging to intraoperative findings and reviewed patient characteristics and prior treatments.
Key results:
  • Among the 222 patients, 86 had endometriomas, all at stage III-IV endometriosis.
  • All bilateral endometriomas were associated with stage IV, while 66.67% of left-sided endometriomas were linked to stage III.
  • Endometrioma size did not correlate with the disease stage.
  • Pre-operative diagnoses of dysmenorrhea and leiomyoma were significantly associated with endometriomas.
  • MRI and ultrasound were strongly effective for endometrioma diagnosis.'
  • Patients on medical therapy for over 12 months had earlier-stage disease, while those treated for less than 3 months had a higher incidence of advanced stage disease.

Lay Summary

A new study published in the Journal of Clinical Medicine by Dr.Nezhad's group reveals that endometriomas, a form of deeply infiltrating endometriosis, are strongly associated with advanced stages of the disease. 

The authors investigated how the presence of endometriomas—whether on one side or both—correlates with more advanced stages of the disease, and how detecting these cysts before surgery can aid in planning, improve patient advice, and handle complex cases, especially those involving fertility. Medical records from 222 patients who had surgery for endometriosis between 2016 and 2021 were reviewed and pre-operative imaging with surgical findings was compared to assess how well different tests and symptoms predict the severity of the disease.

 

The study included 222 patients, 86 had endometriomas, all at advanced rASM stages (III or IV) of endometriosis. Endometriomas on both ovaries were always linked to stage IV, while left-sided ones were often associated with stage III. The size of the endometriomas was not related to the disease stage. Painful periods and fibroids before surgery were strongly linked to endometriomas, but age and previous surgeries were not. MRI and ultrasound were highly effective in diagnosing endometriomas. Longer medical treatment was connected to earlier disease stages, while shorter treatment often resulted in advanced stage IV. Detecting endometriomas via imaging helps in better surgical planning and improves patient care.

 Detecting these cysts through imaging before surgery can improve how surgeries are planned, offer valuable information about the disease, and enhance patient care and referrals.

Research Source: https://pubmed.ncbi.nlm.nih.gov/39124796/

endometriomas endometriosis ASRM staging ASRM classification

DISCLAIMER

EndoNews highlights the latest peer-reviewed scientific research and medical literature that focuses on endometriosis. We are unbiased in our summaries of recently-published endometriosis research. EndoNews does not provide medical advice or opinions on the best form of treatment. We highly stress the importance of not using EndoNews as a substitute for seeking an experienced physician.

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