Recurrence of ovarian endometriosis and anatomical location of the primary lesion

Objective: To investigate whether the risk of endometriosis recurrence and pregnancy rate are related to the side of the pelvis on which the primary lesion is found. Design: Cross-sectional study. Setting: Tertiary institutional hospital. Patient(s): One hundred and twenty-one patients with advanced-stage pelvic endometriosis. Intervention(s): Conservative laparoscopic treatment. Main Outcome Measure(s): Endometriosis recurrence and pregnancy rate. Result(s): Endometriosis was localized on the left hemipelvis, right hemipelvis, and bilaterally in 47.9%, 33.9%, and 18.2% of patients, respectively. The overall rate of disease recurrence was 17.3%. The recurrence rate was higher when the left ovary was involved than when it was not (29% vs. 7.3%; P<.05). The overall rate of spontaneous pregnancy was 48.1%. The median interval between surgery and occurrence of pregnancy was shorter in patients with endometriosis limited to the right hemipelvis than in those with disease limited to the left side (21 months [range, 12-48 months] vs. 9 months [range, 6-12 months]; P<.01). Conclusion(s): The likelihood of disease recurrence is lower when endometriosis is located only on the right side of the pelvis than when the left side is involved. In patients who try to conceive, the time between surgery and occurrence of pregnancy seems to be shorter when the endometriosis is localized in the right hemipelvis. (C) 2001 by American Society for Reproductive Medicine.