This protocol addresses patients with an ovarian endometriotic cyst presenting with endometriosis-associated pelvic pain or dysmenorrhea, in whom prior medical treatment did not achieve adequate cyst reduction or symptom control.
Dysmenorrhea is among the most common symptoms in younger patients with this condition and, if inadequately managed, may progress to endometriosis-associated infertility.
Medical treatment — typically a GnRH agonist (the most widely used option), or alternatives including danazol, oral contraceptives, gestrinone, or dienogest — did not achieve the intended goals: reduction in the size of the endometriotic cyst and adequate control of pelvic pain and dysmenorrhea.
Surgery is considered the first-line approach for pain in women with an endometriotic cyst when medical therapy has not been sufficient. The intervention is conservative in intent — the full selection criteria, procedural details, and decision algorithm are in the complete protocol.
Treatment goals: reduced recurrence of dysmenorrhea, dyspareunia, and chronic pelvic pain. Full protocol accessible below.
DOI: 10.1007/s13669-011-0002-3
The most common symptom in younger patients is endometriosis-associated pain including dysmenorrhea, which, if mistreated, may lead to endometriosis-associated infertility.
Surgery is thought to be the first line of treatment for pain in women with endometriotic cyst.
Ovarian cystectomy is a more definite treatment for endometriotic cyst.
Although several studies found no difference among various surgical procedures, including drainage, ablation, and cystectomy, randomized trials indicated a lower cumulative postoperative rate of recurrence of dysmenorrhea, dyspareunia, and chronic pelvic pain in patients who underwent cystectomy compared with those who underwent drainage alone.