Reconstruction of the Ovary with Endometrioma: A Problem of Adhesions
In situ examination of ovaries with a chocolate cyst has shown that the endometrioma is not an intraovarian cyst of deeply infiltrating endometriosis but an extraovarian pseudocyst consisting of invaginated ovarian cortex fused and sealed off by adhesions and colonized by superficial endometriotic implants. If the adhesions and menstrual bleeding of superficial implants are the cause of the pseudocyst formation, the rational surgical approach is lysis of adhesions and ablation of superficial endometriosis. This chapter describes the nosography of the ovarian endometriotic cyst, the observations that support the thesis of an extraovarian pseudocyst, and proposes adhesiolysis, eversion via the stigma of inversion, and coagulation of superficial implants as the first-choice surgical treatment.
KeywordsEstrogen Argon Adenocarcinoma Progesterone Perforation
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