Johnstone Erica B, Link Megan H
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, Utah.
Clin Obstet Gynecol. 2015 Dec;58(4):754-64. doi: 10.1097/GRF.0000000000000151.
Endometriomas are common in reproductive-aged women, but controversy exists regarding their management. PubMed was searched to identify pertinent studies on outcomes of medical and surgical management of endometrioma, with focus on randomized controlled trials and meta-analyses. Surgical excision is more effective than fenestration/coagulation of endometrioma for pelvic pain but decreases antimullerian hormone. It may modestly improve the chances of spontaneous pregnancy, but does not impact chances of success with in vitro fertilization. Oral contraceptive pills improve dysmenorrhea but not dyspareunia or noncyclic pelvic pain. Management of the patient with endometrioma should be individualized based on each patient's particular symptoms and short-term and long-term fertility goals.
卵巢子宫内膜异位囊肿在育龄女性中很常见，但关于其治疗仍存在争议。检索了PubMed以确定关于卵巢子宫内膜异位囊肿药物和手术治疗结果的相关研究，重点是随机对照试验和荟萃分析。手术切除在缓解盆腔疼痛方面比卵巢子宫内膜异位囊肿开窗/凝固术更有效，但会降低抗苗勒管激素水平。它可能会适度提高自然受孕的几率，但不影响体外受精的成功率。口服避孕药可改善痛经，但不能改善性交困难或非周期性盆腔疼痛。对于卵巢子宫内膜异位囊肿患者的治疗应根据每个患者的具体症状以及短期和长期生育目标进行个体化。
