Preoperative Medication for Ovarian Endometrioma Reduces Cyst Size and Pain but Not rASRM Score

To investigate the impact of preoperative hormonal medication, including combined oral contraceptives or dienogest, on operative findings in ovarian endometrioma surgery.

A single-center, retrospective study.

Department of Gynecology, Samsung Medical Center, Republic of Korea.

Among patients who underwent ovarian endometrioma surgery for the first time at Samsung Medical Center between January 2020 and July 2023, those who started hormonal medication at another institution before their initial visit to our center, those with a waiting period of less than 3 months until the surgery date, and those with an endometrioma size of less than 4 cm at the initial visit were excluded. A total 140 remaining patients were included in the study. The patients were divided into two groups: the group that received preoperative hormonal medication (combined oral contraceptives or dienogest) and the group that did not receive medication.

To evaluate the impacts of preoperative hormonal medication on ovarian endometrioma patients, the operative findings were compared between the groups.

Of the 140 patients, 65 were in the no-medication group and 75 were in the medication group. Except for the median duration of follow-up and age, there were no differences in the baseline characteristics between the two groups. Operative findings were quantified using the revised American Society for Reproductive Medicine score. Although medication significantly reduced the size of the ovarian endometrioma, there were no significant differences in revised American Society for Reproductive Medicine score between the two groups. However, the medication group experienced significant preoperative pain relief.

Preoperative hormonal medication can reduce the size of ovarian endometriomas but does not significantly affect the overall operative findings. Nevertheless, preoperative medication is helpful in reducing pain in patients before surgery.