Three Different Laparoscopic Approaches for Ovarian Endometrioma and the Effect on Ovarian Reserve

Abstract

Endometriosis¶is¶a¶benign,¶estrogen-dependent¶gynecological¶disease¶characterized¶by¶endome-trial¶tissue¶located¶outside¶the¶uterus.¶It¶commonly¶located¶in¶pelvis¶but¶can¶occur¶elsewhere¶in¶the¶body. Diagnosis¶of¶endometriosis¶is¶considered¶in¶the¶presence¶of¶gynecological¶symptoms¶such¶as:¶dysmenorrhea,¶non-cyclical¶pelvic¶pain,¶deep¶dyspareunia,¶infertility.¶The¶GDG¶recommends¶that¶clinicians¶should¶consider¶the¶diagnosis¶of¶endometriosis¶in¶women¶of¶reproductive¶age¶with¶(dyschezia,¶dysuria,¶hematuria,¶rectal¶bleeding,¶and¶shoulder¶pain). A¶pelvic¶examination¶should¶be¶performed;¶the¶most¶common¶finding¶is¶tenderness¶when¶palpating¶the¶posterior¶vaginal¶fornix.¶Rectal¶examination¶can¶be¶helpful¶for¶the¶diagnosis¶of¶endometriosis¶in¶those¶without¶previous¶sexual¶intercourse. Ultrasound¶is¶typically¶first-line¶study¶for¶pelvic¶imaging¶in¶women.¶However,¶several¶studies¶were¶performed¶to¶evaluate¶the¶accuracy¶of¶TVS¶in¶ovarian¶endometriosis¶diagnosis. The¶accuracy¶of¶laparoscopic¶diagnosis¶depends¶upon¶the¶location¶and¶type¶of¶the¶lesion,¶the¶experience¶of¶the¶operator,¶and¶whether¶disease¶is¶mild¶or¶extensive¶Experience¶of¶the¶operator.