Unlü Cihat, Yıldırım Gazi
Department of Obstetrics and Gynecology, Acıbadem University, Bakırköy Acıbadem Hospital, İstanbul, Turkey.
Department of Obstetrics and Gynecology, Yeditepe University Hospital, İstanbul, Turkey.
J Turk Ger Gynecol Assoc. 2014 Aug 8;15(3):177-89. doi: 10.5152/jtgga.2014.1111. eCollection 2014.
Endometrioma is one of the most frequent adnexal masses in the premenopausal population, but the recommended treatment is still a subject of debate. Medical therapy is inefficient and can not be recommended in the management of ovarian endometriomas. The general consensus is that ovarian endometriomas larger than 4 cm should be removed, both to reduce pain and to improve spontaneous conception rates. The removal of ovarian endometriomas can be difficult, as the capsule is often densely adherent. While the surgical treatment of choice is surgical laparoscopy, for conservative treatment, the preferred method is modified combined cystectomy. Cystectomy can be destructive for the ovary, whereas ablation may be incomplete, with a greater risk of recurrence. To the best of our knowledge, the modified combined technique seems to be more efficient in the treatment of endometriomas.
子宫内膜异位囊肿是绝经前人群中最常见的附件肿块之一，但推荐的治疗方法仍存在争议。药物治疗效果不佳，在卵巢子宫内膜异位囊肿的管理中不推荐使用。普遍的共识是，大于4厘米的卵巢子宫内膜异位囊肿应予以切除，以减轻疼痛并提高自然受孕率。切除卵巢子宫内膜异位囊肿可能很困难，因为囊肿包膜常常紧密粘连。虽然首选的手术治疗方法是腹腔镜手术，但对于保守治疗，首选方法是改良联合囊肿切除术。囊肿切除术可能会对卵巢造成损害，而消融术可能不彻底，复发风险更高。据我们所知，改良联合技术在治疗子宫内膜异位囊肿方面似乎更有效。
