Эндометриома яичника. Стратегия хирургического лечения и послеоперационной гормональной терапии

Ovarian endometrioma. Strategy for surgical treatment and postoperative hormone therapy

For several decades, the problem of ovarian endometriosis has been the focus of attention of scientists all over the globe. However, it remains a relevant issue and is the subject of numerous discussions and debates. One of the key topics in this problem are still the management tactics and strategies for patients with ovarian endometriomas. Generally, these are young women, and their treatment should be aimed at preserving their reproductive potential, which is initially impaired by ovarian endometriosis. Oncological caution and the toxicity of ovarian endometriomas together indicate the need for surgical treatment. From a critical perspective based on personal experience and data from recent international publications, all currently available organ-preserving surgical methods used in patients with ovarian endometriomas are reviewed: cystectomy, ablation, and sclerotherapy. The aggressiveness of cystectomy in relation to ovarian reserve is demonstrated, and the limitations of ablation and ethanol sclerotherapy are emphasized. Special attention is paid to the prevention of postoperative recurrence of ovarian endometriomas, in which hormone therapy plays an important role. In this context, the advantages of combined oral contraceptives containing dienogest are justified. © 2025, Dynasty Publishing House. All rights reserved.