Évaluation par échographie tridimensionnelle de la réduction du volume des ovaires après kystectomie des endométriomes

Abstract

Objective The aim of our study was to assess ovarian tissue loss related to endometrioma cystectomy by 3D-ultrasonography. Patients and methods We have retrospectively included 15 women with no previous ovarian surgery who benefited from cystectomy of an unilateral endometrioma the diameter of which was superior to 30 mm. Cystectomy has been performed using an ovarian tissue-sparing procedure with no incision of the ovarian cortex. Patients underwent ultrasonography at least 9 months after the surgery. Several ovarian parameters, such as the area on longitudinal cross-section, the volume and the antral follicles count (AFC), were measured on both operated and contra lateral ovary, and then were compared using Mann and Whitney test. The relationship between the reduction of operated ovary volume and preoperative endometrioma diameter was evaluated by multiple regression. Results Operated ovary presented a significant reduction in area (mean reduction 229.8 mm 2 ± 47.6; P < 0.0001), volume (mean reduction 5.8 cm 3 ± 1.16; P < 0.0001) and AFC (mean reduction 5.1 ± 3.8, P = 0.002). No statistically significant correlation was found between operated ovary volume reduction and preoperative endometrioma diameter. Discussion and conclusion Endometrioma cystectomy leads to significant reduction in ovarian parenchyma volume and AFC, when compared to contra lateral ovary. This event must be taken into account in the choice of treatment strategy, especially in the case of enlarged, bilateral and recurrent endometriomas, recurrence, as well as in women presenting with other risk factor for ovarian failure.