Characteristics of Ovarian Endometriotic Cysts Could Help Determine Whether Endometrioma Will Reoccur

They found that there were statistically significant differences between patients in whom endometrioma reoccurred and those for whom it did not in terms of age, thickness of fibrosis, and depth of penetration of endometrial tissue into the cyst wall.

The features of ovarian endometriotic cysts could help predict whether endometrioma will re-occur in individual patients, according to a study published in the European Journal of Obstetrics and Gynecology. Predicting the risk of recurrence is important because it can help doctors better manage the condition.

“Knowing the recurrence risk of an endometrioma will help in deciding the optimal treatment modalities for each individual patient,” wrote Dr. Selcuk and colleagues at Zeynep Kamil Training and Researching Hospital in Istanbul, Turkey. “High risk patients should be offered appropriate treatments according to the clinical status without delay and low-risk patients should be protected from over-treatment”.

The team retrospectively evaluated patients of reproductive age who had been diagnosed with ovarian endometrioma and who underwent surgery to remove the endometriotic cysts. They determined several characteristics of the cysts including the thickness of the cyst wall, the thickness of fibrosis or scarring, the thickness of the ovarian tissue, the number of follicles per cyst, and the depth of penetration of endometrial tissue into the cyst wall.

As possible risk factors for the recurrence of endometrioma, the researchers also determined the age of the women at surgery, the number of pregnancies they had, their clinical symptoms such as painful periods and infertility, and cysts features such as bilaterality and cyst diameter.

They found that there were statistically significant differences between patients in whom endometrioma reoccurred and those for whom it did not in terms of  age, thickness of fibrosis, and depth of penetration of endometrial tissue into the cyst wall.

The team calculated that being 35 years old or younger, and the depth of penetration were significant risk factors linked to the recurrence of endometrioma. The depth of penetration, thickness of fibrosis, and the diameter of the cyst determined by ultrasound were inversely correlated with recurrence interval, meaning that the higher these measures were the sooner endometrioma recurred. Statistical analysis showed that the depth of penetration was the only significant risk factor for the recurrence interval. A depth of penetration of 1.2 mm was determined as the cut off value for the presence of recurrence.