Abstract

Endometrioma is one of the most frequent localisations of endometriosis. The diagnosis is based mainly on the intravaginal ultrasonography which has a good predictive value, even if there are a lot of atypical echographic aspects. Endoscopic surgery remains the standard treatment for endometriosis, the goal being the complete removal of the lesions. Three surgical options are possible: intraperitoneal kystectomy, the three-phase “Donnez technique” in three time, and ovariectomy. Treatment of recurrences of endometriosis must be based on a precise diagnosis, and also on the type of patient being treated : patient wishing to be pregnant, patient under medically-assisted reproductive programs, and patients close to menopause. The ultrasound-guided puncture could be an interesting option for multioperated patients or patients under assisted reproductive programs, yet these patients should be informed of the high risk of further episodes of endometriosis after such a puncture.

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