Risk Factors for Symptomatic Recurrence after Laparoscopic Adenomyomectomy: A 3-Year Follow-up.

Study Objective: To identify the clinical risk factors for symptomatic recurrence of adenomyosis after laparoscopic adenomyomectomy with a three-year follow-up.

Design: Retrospective study.

Setting: University-affiliated hospital.

Patients: A total of 149 patients were included in this study, including 52 patients with symptomatic recurrence and 97 without recurrence.

Intervention: Laparoscopic adenomyomectomy was performed first.

Measurements And Main Results: General clinical data, including preoperative, intraoperative, and postoperative indices, symptomatic recurrence, and follow-up information, were collected. Comparison of women with and without symptomatic recurrence revealed significant differences for age at surgery (p = .026), presence of concomitant ovarian endometrioma (p <.001), and prescription of postoperative hormonal suppression (yes/no) (p <.0001). A Cox proportional hazard model indicated that concomitant ovarian endometrioma was a significant risk factor for recurrence (hazard ratio [HR], 2.06; 95% confidence interval [CI], 1.10-3.85, p = .001). Patients who received postoperative hormonal suppression had a lower risk of recurrence than those without hormonal suppression (HR, 0.30; 95% CI, 0.16-0.55, p <.0001). Those aged ≥40 years also had a lower risk of symptomatic recurrence than those <40 years (HR, 0.46; 95% CI, 0.24-0.88, p = .03).

Conclusions: Concomitant ovarian endometrioma is a risk factor for symptomatic recurrence of adenomyosis after laparoscopic adenomyomectomy. Postoperative hormonal suppression and older age at surgery (≥40 years) are protective factors.