Pathological assessment of follicular loss in laparoscopic endometrioma excision: effects of cyst size and surgeon's experience.

Abstract

We planned to histologically demonstrate unintentional ovarian harm caused by excision of endometriomas. One hundred and seven patients with 135 endometriomas had laparoscopic excision of endometriomas at a tertiary health-care clinic over a 6-year period. Records were obtained retrospectively and pathological specimens were reevaluated to demonstrate follicular loss. Tissue damage was scored morphologically and compared according to surgeons' experience and endometrioma size. Ovarian follicles were detected in 80% of endometrioma specimens near the cyst wall. Morphological scores of ovarian follicles were not affected by the surgeon's experience or endometrioma size. Surgical excision of endometriomas causes inevitable ovarian follicular loss. As observed in our study, this loss rate could not be traced to surgical experience or ovarian size.