{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:10:00Z","timestamp":1791180600737,"version":"4.1.0"},"reference-count":37,"publisher":"S. Karger AG","issue":"1-2","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gynecol Obstet Invest"],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Objectives:&lt;\/i&gt;&lt;\/b&gt; Up to 32% of women experience anatomic recurrence after conservative surgery for endometriomas, while pain recurs in 10\u201340% of cases. Long-term postoperative hormonal therapy is recommended to prevent disease recurrence. We evaluated the efficacy of long-term therapy with estroprogestins (EPs) or progestins (Ps) in preventing endometrioma recurrence, as identifiable cysts and subjective symptoms, after laparoscopic excision. &lt;b&gt;&lt;i&gt;Design:&lt;\/i&gt;&lt;\/b&gt; This retrospective cohort study included 375 women submitted to laparoscopic endometrioma excision. Women were followed up at 6 and 12 months and then yearly after surgery. Based on postoperative medical therapy, women were divided into 4 groups: nonusers, cyclic EP users, continuous EP users, and progestogen users. &lt;b&gt;&lt;i&gt;Materials, Setting, Methods:&lt;\/i&gt;&lt;\/b&gt; Anamnestic and anthropometric characteristics were collected as well as clinical and surgical data. Gynecological examination, and transvaginal and transabdominal ultrasound scans were performed. Pain (numerical rating score &amp;#x3e;5) and endometrioma recurrence at ultrasound (ovarian cyst with typical sonographic features \u226510 mm in mean diameter) were recorded at each examination. The reoperation rate in women with recurrence was investigated. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; The median follow-up was 3.7 years with a maximum of 16.7 years. Most patients used EPs (119 cyclic and 61 continuous users), 95 used P, and 100 were nonusers. In 135 women (36%), endometriotic cyst recurrence was diagnosed, with a mean diameter of 18.7 \u00b1 10.8 mm (range 10\u201355 mm). The median recurrent cyst-free time was 7.9 years (95% CI 5.8\u201310.8). Dysmenorrhea was the first symptom to reappear, affecting 162 patients (43.2%). Upon multivariable regression analysis, continuous users had a lower risk of relapse (OR 0.56, 95% CI 0.32\u20130.99), in terms of both cysts and symptom recurrence, than patients who received no medications. The reoperation rate was 16.2%. &lt;b&gt;&lt;i&gt;Limitations:&lt;\/i&gt;&lt;\/b&gt; The main limitation of this study is its retrospective design. Also, women switching therapies throughout the follow-up period were sorted into one of the study groups based on the longest treatment taken, without considering the discontinuation rates. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; Long-term EPs, administered in a continuous regimen and starting immediately after conservative surgery for endometriomas, seem to reduce the disease recurrence risk. <\/jats:p>","DOI":"10.1159\/000514310","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T21:03:59Z","timestamp":1618347839000},"page":"170-176","source":"Crossref","is-referenced-by-count":14,"title":["Long-Term Medical Therapy after Laparoscopic Excision of Ovarian Endometriomas: Can We Reduce and Predict the Risk of Recurrence?"],"prefix":"10.1159","volume":"86","author":[{"given":"Simona","family":"Del 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