Treatment of Ovarian Endometriosis

  • Camran Nezhat
  • Farr Nezhat
  • Ceana Nezhat
  • Dahlia Admon

Abstract

Ovarian involvement occurs in 50% to 70% of all cases of endometriosis.1 Lesions appear differently at the ovary than at other sites. Superficial ovarian endometriosis, like endometriosis of other parts of the pelvis, can be treated by excision, vaporization or coagulation. Irrigation is performed and all of the charcoal is removed to be sure that the disease is completely treated. Aggressive use of the laser or electrocoagulation should be avoided to decrease the chance of ovarian damage. Ovarian endometriosis may form cystic structures known as endometriomas.

Keywords

Estrogen Diarrhea Barium Progesterone Androgen 

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References

  1. 1.
    Jenkins S, Olive DL, Haney AF. Endometriosis: pathogenic implications of the anatomic distribution. Obstet Gynecol 1986;67:335.PubMedGoogle Scholar
  2. 2.
    Vercellini P, Vandola N, Bocciolone L, et al. Laparoscopic aspiration of ovarian endometriomas. J Reprod Med 1992;37:577.PubMedGoogle Scholar
  3. 3.
    Fayez JA, Vogel MF. Comparison of different treatment methods of endometriomas by laparoscopy. Obstet Gynecol 1991;78:660.PubMedGoogle Scholar
  4. 4.
    Kupfer MC, Schwimer SR, Lebovic J. Transvaginal sonographic appearance of endometrioma: spectrum of findings. J Ultrasound Med 1992;11:129.PubMedGoogle Scholar
  5. 5.
    Grabb A, Carr L, Goodman JD, et al. Hepatic endometrioma. J Clin Ultrasound 1986;14:478.PubMedCrossRefGoogle Scholar
  6. 6.
    Kennedy SH, Brodribb J, Godfrey AM, et al. Preoperative treatment of an abdominal wall endometrioma with nafarelin acetate: case report. Br J Obstet Gynecol 1988; 95:521.CrossRefGoogle Scholar
  7. 7.
    Frydman CP, Schwartz JW, Schwartz IS. Endometrioma of the anterior abdominal wall. Mount Sinai J Medicine 1986;53:160.Google Scholar
  8. 8.
    Punnonen R, Pettersson K, Vanharanta R, et al. Androgen, estrogen and progestin binding in cystosis of benign gynecologic tumors and tumor-like lesions. Hormone and Metabolic Research 1985;7:607.CrossRefGoogle Scholar
  9. 9.
    Botha AJ, Halliday AE, Flanagan JP. Endometriosis in gluteus muscle with surgical implantation: a case report. Acta Orthopaedica Scandinavica 1991;62:497.PubMedCrossRefGoogle Scholar
  10. 10.
    Lipscomb GH, Ling FW, Photopoulos GJ. Ovarian abscess arising within an endometrioma. Obstet Gynecol 1991;78:951.PubMedGoogle Scholar
  11. 11.
    Martino CR, Haaga JR, Bryan PJ. Secondary infection of an endometrioma following fine-needle aspiration. Radiology 1984;151:53.PubMedGoogle Scholar
  12. 12.
    Martin JD, Hauck AE. Endometriosis in the male. Am Surg 1985;51:426.PubMedGoogle Scholar
  13. 13.
    Johnson TR, Woodruff JD. Surgical emergencies of the uterine adnexae during pregnancy. Int J Gynecol Obstet 1986;24:331.CrossRefGoogle Scholar
  14. 14.
    Pennes DR, Bowerman RA, Silver TM. Echogenic adnexal masses associated with first-trimester pregnancy: sonographic appearance and clinical significance. J Clin Ultrasound 1985;13:391.PubMedCrossRefGoogle Scholar
  15. 15.
    Ninia JG. Large endometrioma with intrauterine pregnancy. NY State J Med 1992;92:364.Google Scholar
  16. 16.
    Nezhat F, Nezhat C, Silfen S, et al. Laparoscopic ovarian cystectomy during pregnancy. J Laparoendosc Surg 1991; 1:161–164.PubMedCrossRefGoogle Scholar
  17. 17.
    Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Arch Surg 1921;3:245.Google Scholar
  18. 18.
    Sampson JA. The development of the implantation theory for the origin of peritoneal endometriosis. Am J Obstet Gynecol 1940;40:549.Google Scholar
  19. 19.
    Chernobilsky B, Morris WJ. A historic study of ovarian endometriosis with emphasis on hyperplastic and atypical changes. Obstet Gynecol 1979;53:318.Google Scholar
  20. 20.
    Nisolle-Pochet M, Casanas-Roux F, Donnez J. Histologic study of ovarian endometriosis after hormonal therapy. Fertil Steril 1988;49:423.PubMedGoogle Scholar
  21. 21.
    Martin DC, Berry JD. Histology of chocolate cysts. J Gynecol Surg 1990;6:43.CrossRefGoogle Scholar
  22. 22.
    Vercellini P, Vendola N, Bocciolone L, et al. Reliability of the visual diagnosis of ovarian endometriosis. Fertil Steril 1991;56:1198.PubMedGoogle Scholar
  23. 23.
    Sternberg SS, ed. Histology for pathologists, 1992, p. 513.Google Scholar
  24. 24.
    Nezhat F, Nezhat C, Allan CJ, et al. Clinical and histologic classification of endometriomas. J Reprod Med 1992; 37:771.PubMedGoogle Scholar
  25. 25.
    Nezhat C, Nezhat F. Letter-to-the-Editor: Comparison of different treatment methods of endometriomas by laparoscopy. Obstet Gynecol 1991;79:315.Google Scholar
  26. 26.
    Killackey M, Neuwirth R. Evaluation and management of pelvic mass: a review of 540 cases. Am J Obstet Gynecol 1988;71:319.Google Scholar
  27. 27.
    Pittaway DE, Fayez JA, Douglas JW. Serum CA-125 in the evaluation of benign adnexal cysts. Am J Ob Gyn 1987;157(6):1426–1428.Google Scholar
  28. 28.
    Nezhat F, Nezhat C, Welander CE, et al. Four ovarian cancers diagnosed during laparoscopic management of 1,011 women with adnexal masses. Am J Obstet Gynecol 1992;167:790.PubMedGoogle Scholar
  29. 29.
    Wood C, Maher P, Hill D. Diagnosis and surgical management of endometriomas. Aust NZ J Obstet Gynecol 1992;32:161.CrossRefGoogle Scholar
  30. 30.
    Fleisher AC, Rogers WH, Rao BK, et al. Assessment of ovarian tumor vascularity with transvaginal color Doppler sonography. J Ultrasound Med 1991;10:563.Google Scholar
  31. 31.
    Shields RA, Peel KR, MacDonald HN, et al. A prospective trial of computed tomography in the staging of ovarian malignancy. Br J Obstet Gynecol 1985;92:407.CrossRefGoogle Scholar
  32. 32.
    Buy JN, Ghossain MA, Mark AS, et al. Focal hyperdense areas in endometriomas: a characteristic finding on CT. Am J Roentgen 1992;159:769.Google Scholar
  33. 33.
    Arrive L, Hricak H, Martin MC. Pelvic endometriosis: MR imaging. Radiol 1989;171:687.Google Scholar
  34. 34.
    Togashi K, Nishimura K, Kimura I, et al. Endometrial cysts: diagnosis with MR imaging. Radiol 1991;180:73.Google Scholar
  35. 35.
    Mawhinney RR, Powell MC, Worthington BS, et al. Magnetic resonance imaging of benign ovarian masses. Br J Radiol 1988;61:179.PubMedCrossRefGoogle Scholar
  36. 36.
    Koninckx PR, Muyldermand M, Moerman P, et al. CA 125 concentrations in ovarian “chocolate” cyst fluid can differentiate an endometriotic cyst from a corpus luteum. Hum Reprod 1992;7:1314.PubMedGoogle Scholar
  37. 37.
    Buttram VC. Use of danazol in conservative surgery. J Reprod Med 1990;35:82.PubMedGoogle Scholar
  38. 38.
    Dmowski WP, Kapetanakis E, Scommegna A. Variable effects of danazol on endometriosis at 4 low-dose levels. Obstet Gynecol 1982;59:408.PubMedGoogle Scholar
  39. 39.
    Henzl MR, Corson SL, Moghissi K, et al. Administration of nasal nafarelin as compared with oral danazol for endometriosis: a multicenter double blind comparative clinical trial. N Engl J Med 1988;318:485.PubMedCrossRefGoogle Scholar
  40. 40.
    Zorn JR, Matheison J, Risquez F, et al. Treatment of endometriosis with a delayed release preparation of the agonist D-Trp6-luteinizing hormone releasing hormone: long-term follow-up of 50 patients. Fertil Steril 1990;53: 401.PubMedGoogle Scholar
  41. 41.
    Schenken RS. Gonadotropin-releasing hormone analogs in the treatment of endometriomas. Am J Obstet Gynecol 1990;162:579.PubMedGoogle Scholar
  42. 42.
    Nezhat C, Crowgery SR, Garrison C. Surgical treatment of endometriosis via laser laparoscopy. Fertil Steril 1986; 45:778.PubMedGoogle Scholar
  43. 43.
    Nezhat C, Nezhat F, Pennington E. Laparoscopic treatment of infiltrate rectosigmoid colon and rectovaginal septum endometriosis by the technique of videolaparo-scopy and the CO2 laser. Br J Obstet Gynecol 1992; 99:664.CrossRefGoogle Scholar
  44. 44.
    Nezhat C, Winder W, Nezhat F. Is endoscopic treatment of endometriosis and endometrioma associated with better results than laparotomy? Am J Gynecol Health 1988;2:10.Google Scholar
  45. 45.
    Hasson HM. Laparoscopic management of ovarian cysts. J Reprod Med 1990;35:863.PubMedGoogle Scholar
  46. 46.
    Nezhat C, Nezhat F. Postoperative adhesion formation after ovarian cystectomy with and without ovarian reconstruction. Presented at the 75th Annual Meeting of the American Fertility Society, Orlando, Florida, October 19–24, 1991.Google Scholar
  47. 47.
    Canis M, Mage G, Wattiez A, et al. Second-look laparoscopy after laparoscopic cystectomy of large ovarian endometriomas. Fertil Steril 1992;58:617.PubMedGoogle Scholar
  48. 48.
    Nezhat C, Nezhat F, Metzger D, et al. Adhesion reformation after reproductive surgery by videolaseroscopy. Fertil Steril 1990;53:1008.PubMedGoogle Scholar
  49. 49.
    Yu J, Grimes DA. Ascites and pleural effusions associated with endometriosis. Obstet Gynecol 1991;78:533.PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc. 1995

Authors and Affiliations

  • Camran Nezhat
  • Farr Nezhat
  • Ceana Nezhat
  • Dahlia Admon

There are no affiliations available

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