Ovarian cystectomy versus laser vaporization in the treatment of ovarian endometriomas: a randomized clinical trial with a five-year follow-up

Objective: To investigate the effect of two laparoscopic techniques for treatment of ovarian endometriomas on recurrence rate. Design: Prospective randomized clinical trial. Setting: University teaching hospital. Patient(s): Ninety women with ovarian endometriomas. Intervention(s): Patients were randomly selected to undergo either laparoscopic cystectomy (group 1) or laser vaporization (group 2) of ovarian endometrioma. Main Outcome Measure(s): Recurrence, evaluated by ultrasound scan examination, was assessed at 12 and 60 months of follow-up. Result(s): Endometrioma recurrence rate was higher, though not significantly different, in group 2 at 60 months of follow-up. Nevertheless, at 12 months of follow-up recurrences were statistically higher in group 2. Conclusion(s): The comparison between laparoscopic laser ablation and laparoscopic cystectomy for ovarian endometriomas after long-term follow-up showed earlier recurrences and a higher recurrence rate in the laser group, although at 5 years of follow-up there were no statistically significant differences. (Fertil Steril (R) 2011;96:251-4. (C) 2011 by American Society for Reproductive Medicine.)