Improvement of pain after Laparoscopic Ovarian Cystectomy of Ovarian Endometriomas versus Deroofing

Background: Endometriosis is characterized by presence of ectopic endometrial glands and stroma outside uterine cavity. It presents with pelvic pain, dysmenorrhea, and infertility, affecting 7–10% of the general female population and up to 50% of women with infertility.
Objective:This study aimed to evaluate the effect on pain intensity following treatment of ovarian endometriomas using either deroofing or ovarian cystectomy.
Methods: This randomized experiment was conducted on 34 women who were eligible for laparoscopic surgery due to endometriomas. The patients were randomly assigned into two equal groups: Cystectomy group: complete removal of the whole cyst within the cyst wall and deroofing group by making a permanent opening at the cyst wall to permit drainage.
Results: At 8 weeks postoperatively, the studied groups were comparable in terms of percent change in VAS pain score compared to preoperative values, whereas at 6 months postoperatively, a statistically significant difference was observed, with the cystectomy group showing a significantly greater percent decrease in measures. At 8 weeks postoperatively, no patients had recurrence. The recurrence rates at 6 months postoperatively were comparable between the studied groups, with no statistically significant difference.
Conclusion: Ovarian cystectomy and deroofing methods were similar regarding recurrence 6 months postoperatively and VAS pain score preoperatively or 8 weeks postoperatively. Ovarian cystectomy and deroofing methods decreased VAS pain score 8 weeks and 6 months postoperatively. Cystectomy is regarded as the gold-standard surgical technique due to its lower risk of ovarian endometriomas (OMA) recurrence and endometriosis related pain.