Ablative or excisional laparoscopic surgery for endometriotic cysts: resolving the issue

A logistic regression analysis was carried out to compare laparoscopic excision with ablation for endometriotic cysts. Four comparative studies were identified. Cyst recurrence (%, +/- SE) was twice as likely after the ablation treatment (26.6% +/- 0.032) than after the excision treatment (13.2% +/- 0.019), (p <.001, relative risk 1.9). Two comparative studies were identified where postprocedure pregnancy rates were an outcome measure. Postoperative pregnancy rates were not significantly different for the ablation treatment (41.6% +/- 0.138) than for the excision treatment (56.9% +/- 0.23). There was only one comparative study to investigate symptom relief, therefore logistic regression analysis to compare studies was not possible. Three studies compared excisional surgery and perioperative medication with excisional surgery only. Cyst recurrence rates were not significantly different for the group that received medication (10.3% +/- 0.033) than for the group that did not (4.0% +/- 0.02).