Retrospective analysis of follicle loss after laparoscopic excision of endometrioma compared with benign nonendometriotic ovarian cysts

Abstract

Objective To evaluate follicle loss in ovarian tissue after laparoscopic excision by the stripping technique in endometriomas versus benign nonendometriotic ovarian cysts. Methods Cystectomy samples obtained from 127 ovaries from 104 patients (mean age, 29.05 ± 05 years; range, 19–40 years) by laparoscopic excision (61 endometriomas and 66 benign nonendometriotic cysts) were evaluated for follicle loss. The samples including normal ovarian tissue were graded on a semiquantitative scale from 0 to 4, where 0 was complete absence of follicles and 4 was the pattern of primary and secondary follicles seen in a normal ovary. The results from endometriomas were compared with those from nonendometriotic cysts. Results There were no differences in mean tissue thickness, or number of primordial, primary, or secondary follicles between the endometriomas and the nonendometriotic cysts ( P > 0.05). Ovarian cortex was detected in 92% and 82% of the endometriomas and nonendometriotic samples, respectively, ( P = 0.081). Semiquantitative scoring of ovarian tissue was significantly higher in endometriomas (1.64 ± 1.35 versus 1.11 ± 1.22, P = 0.022). Conclusion In up to 92% of the cystectomy samples, normal ovarian tissue was found adjacent to the benign cyst; however, functional follicle loss was slightly, but significantly, higher in the endometriomas.