'Blood On The Tracks' from corpora lutea to endometriomas
P Vercellini1, E Somigliana, P Vigano
1Università degli Studi di Milano, Milan, Italy. paolo.vercellini@unimi.it
Objective:
To detect a direct transition from a haemorrhagic corpus luteum to an endometriotic cyst by serial transvaginal ultrasonographic scans.
Design:
Prospective observational study.
Setting:
An academic tertiary care and referral centre for women with endometriosis.
Population:
One hundred and nine women younger than 40 years, with regular menstrual cycles, undergoing first-line surgery for endometriomas, and not wanting postoperative oral contraception.
Methods:
Three-monthly transvaginal ultrasonography during the luteal phase for 2 years after surgery.
Main Outcome Measure:
Sonographic identification of progression from a haemorrhagic corpus luteum to a recurrent endometriotic cyst.
Results:
A haemorrhagic corpus luteum was identified in 13 women. Serial ultrasonographic scans demonstrated transition to an endometriotic cyst in 11 (85%) instances and resorption in two. A unilateral endometriotic cyst without previous detection of a cystic corpus luteum was observed in 14 women.
Conclusions:
Bleeding from a corpus luteum appears to be a critical event in the development of endometriomas.
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