Post-operative endometriosis recurrence: a plea for prevention based on pathogenetic, epidemiological and clinical evidence Paolo Vercellini, Edgardo.

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Presentation transcript:

Post-operative endometriosis recurrence: a plea for prevention based on pathogenetic, epidemiological and clinical evidence Paolo Vercellini, Edgardo Somigliana, Paola Viganò, Sara De Matteis, Giussy Barbara, Luigi Fedele Reproductive BioMedicine Online Volume 21, Issue 2, Pages 259-265 (August 2010) DOI: 10.1016/j.rbmo.2010.04.018 Copyright © 2010 Reproductive Healthcare Ltd. Terms and Conditions

Figure 1 Cumulated literature data from studies reporting recurrence of endometriosis showing a gradual but steady increase in recurrence figures over the first 5 years of follow-up. From Evers et al. (1991). Reproduced with permission from the publisher. Reproductive BioMedicine Online 2010 21, 259-265DOI: (10.1016/j.rbmo.2010.04.018) Copyright © 2010 Reproductive Healthcare Ltd. Terms and Conditions

Figure 2 Thirty-six-month endometrioma recurrence-free survival analysis after conservative laparoscopic surgery according to the treatment modality adopted. (A) Oral contraception used for the entire follow-up period (n=102). (B) Oral contraception used discontinuously (n=129). (C) Expectant management (n=46). Pairwise log-rank test over strata: A versus B, P<0.001; A versus C, P<0.001; B versus C, P=−0.045. Vertical tick marks are censored observations. Modified from Vercellini et al. (2008b). Reproduced with permission from the publisher. Reproductive BioMedicine Online 2010 21, 259-265DOI: (10.1016/j.rbmo.2010.04.018) Copyright © 2010 Reproductive Healthcare Ltd. Terms and Conditions

Figure 3 Results of studies comparing conservative surgery for ovarian endometriomas with or without post-operative long-term oral contraceptive use. Horizontal lines indicate 95% CI; boxes show the study-specific weight; rhombi represent combined effect sizes; dashed line indicates the overall estimate. DerSimonian-Laird test for heterogeneity: chi-squared=6.07, P=0.014. OC=oral contraceptive; OR=odds ratio. Reproductive BioMedicine Online 2010 21, 259-265DOI: (10.1016/j.rbmo.2010.04.018) Copyright © 2010 Reproductive Healthcare Ltd. Terms and Conditions