Treatment of ovarian endometriomas using laparoscopic surgical techniques.

Seventy-nine cases of ovarian endometrioma were treated via the laparoscope. The surgical technique gradually evolved from drainage alone to fulguration and finally to excision of the endometrioma cyst wall. Indications for laparoscopy were infertility (35 cases), pain (33), hypermenorrhea (5) and pelvic mass (4); the condition was an incidental finding in 2 cases. There were no intraoperative or postoperative complications. The long-term results, especially the fertility outcome, have been promising: 12 of 20 women (60%) achieved a term pregnancy following a laparoscopic endometrioma procedure alone. Of the eight women with endometriomas who did not conceive, six had well-documented male factor infertility.