Complications
Ovarian failure infrequently occurs after excision of ovarian endometrioma. This is probably due to a lowered number of ovarian follicles that produce estrogen.
The benefit of reduced symptom recurrence must be balanced with the risk of ovarian failure (2.4%).[132] Preoperative counseling is critical.
There is evidence that women with endometriosis may have up to a twofold increased relative risk of epithelial ovarian cancers (clear cell and endometrioid type epithelial ovarian carcinoma).[133] However, this amounts to a very small proportion of women with endometriosis, and no standardized screening regimen exists.
Patients often present with vague, nonspecific symptoms such as abdominal bloating, early satiety, and dyspepsia (suggestive of upper abdominal disease). Other symptoms are more suggestive of pelvic disease, such as pelvic pain, abdominal or pelvic pressure, low back pain, and urinary urgency.
Women with a suspicious pelvic mass should be referred to a gynecologic oncologist for further evaluation.
Adhesions probably result from the inflammatory disruption of peritoneal surfaces and are potentiated by surgical trauma. The risk of this occurrence is not well known, and may occur at any point. Sequelae may include pain (although this has yet to be established) and bowel obstruction.
Adhesiolysis predisposes to unrecognized bowel injuries, which may result in postoperative complications such as peritonitis or obstruction.
Use of this content is subject to our disclaimer