Herb-separated moxibustion on dysmenorrhea in ovarian endometriosis: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect of herb-separated moxibustion on dysmenorrhea in ovarian endometriosis.@*METHODS@#A total of 54 patients with ovarian endometriosis dysmenorrhea were randomized into a herb-separated moxibustion group and a waiting-list group, 27 cases in each one (3 cases dropped off in the herb-separated moxibustion group, 4 cases dropped off in the waiting-list group). Herb-separated moxibustion was applied at hypogastrium and lumbosacral area for 30 min in the herb-separated moxibustion group, once a week for 3 months, and oral ibuprofen sustained-release capsule was given to relieve pain when necessary. Excepting giving ibuprofen sustained-release capsule when necessary, no more intervention was adopted in the waiting-list group. Before and after treatment and in 3 months follow-up, visual analogue scale (VAS) score, days of dysmenorrhea, total dose of oral painkiller were observed.@*RESULTS@#Compared before treatment, the VAS scores after tratment and in follow-up were decreased in the herb-separated moxibustion group (<0.05), and were less than those in the waiting-list group (<0.05); the days of dysmenorrhea and the total doses of oral painkiller after tratment and in follow-up were decreased in the herb-separated moxibustion group (<0.05), and were less than those in the waiting-list group (<0.05).@*CONCLUSION@#Herb-separated moxibustion can effectively improve dysmenorrhea symptom and shorten dysmenorrhea days in patients with ovarian endometriosis.

Risk Factors for Recurrence of Ovarian Endometriosis in Chinese Patients Aged 45 and Over / 中华医学杂志(英文版)

<p><b>Background</b>When considering the issue of recurrence, perimenopausal women may have more dilemma during management comparing with young women, for example, whether to retain the uterus and ovary during surgery, whether it is necessary to add adjuvant medicine treatment after operation, and there is no evidence for reference about using of gonadotropin-releasing hormone agonist. This study aimed to study the risk factors for the recurrence of ovarian endometriosis (EM) in patients aged 45 and over.</p><p><b>Methods</b>This is a retrospective nested case-control study. We reviewed the medical records of patients aged over 45 years who underwent surgical treatments for ovarian EM from 1994 to 2014, in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences. By following up to January 2016, 45 patients were found to have relapses and regarded as the recurrence group. The patients with no recurrence during the same follow-up period were randomly selected by the ratio of 1:4 as the nonrecurrence group (180 patients in total). Stratified Cox regression was used to analyze the risk factors of the recurrence.</p><p><b>Results</b>Univariate analysis showed that there was a significant difference in the postoperative treatment (the percentage of patients who received postoperative treatment in non-recurrence group and recurrence group, 23.9% vs. 40.0%, χ = 4.729, P = 0.030) and ovarian preservation (the percentage of patients who received surgery of ovarian preservation in non-recurrence group and recurrence group, 25.0 % vs. 44.4%, χ = 19.462, P < 0.001) between the nonrecurrence group and the recurrence group. There was no correlation between recurrence and the following factors including patient's age, menarche age, gravidity, parity, CA125 level, ovarian lesions, menopausal status, combined benign gynecological conditions (such as myoma and adenomyoma) and endometrial abnormalities, and surgical approach or surgical staging (all P > 0.05). Multivariate analysis indicated that whether to retain the ovary was the only independent risk factor of recurrence for patients aged 45 years and over with ovarian EM (odds ratio: 5.594, 95% confidence interval: 1.919-16.310, P = 0.002).</p><p><b>Conclusion</b>Ovarian preservation might be the only independent risk factor of recurrence for patients aged 45 years and over with ovarian EM.</p>

Expression of AMH in the serum of patients with ovarian endometriosis cyst and its clinical significance / 中国综合临床

Objective To investigate the expression of anti mullerian hormone(AMH)in the serum of patients with ovarian endometriosis cyst and its clinical significance.Methods Fifty-one cases of ovarian endometriosis cyst from March 2014 to June 2016 in Maternal and Child Health Hospital Affiliated to Southern Medical University(observation group)and thirty-five cases of normal women who were diagnosed through physical examination(control group)were selected as the research objects.The observation group patients received laparoscopic ovarian endometriosis cystectomy treatment,enzyme-linked immunosorbent assay(ELISA) was applied to detect and analyze serum AMH in the control group at physical examination and in the observation group before surgery and at 1 month,3 months after surgery.Results (1)The preoperative serum AMH level of the observation group was significantly lower than that of the control group,the difference was statistically significant((2.45±0.68)μg/L vs.(3.75±0.80)μg/L,t=7.8604,P=0.0000).(2)Serum AMH level in the groups where the ages were above 35years was significantly lower than that of the age less than 35 group( (1.76±0.57)μg/L vs.(3.61±0.88)μg/L,t=9.1249,P=0.0000); the preoperative serum AMH level in the group where disease course was more than 12 months was significantly lower than that of the disease course less than 12 months group((2.03 ± 0.64)μg/L vs.(3.98 ± 0.91)μg/L,t=8.1408,P=0.0000); the preoperative serum AMH level in patients with dysmenorrhea was significantly lower than that of patients without dysmenorrhea((1.65±0.53)μg/L vs.(3.91±0.84)μg/L,t=11.7861,P=0.0000),the preoperative serum AMH level in the bilateral lesion group was significantly lower than that of the unilateral lesion((2.01±0.68) μg/L vs.(2.84±0.72)μg/L,t=4.2174,P=0.0001); there was no significant difference in the preoperative serum AMH level between patients with<5.0 cm diameter cyst and patients with smaller cyst((2.52 + 0.81)μg/L vs.(2.39 + 0.50)μg/L,t=0.8411,P=0.4029).The serum AMH level in the observation group at 3 months after surgery was significantly lower than that before surgery((2.45±0.68)μg/L vs.(1.81± 0.55) μg/L,t=24.3657,P=0.0000).Conclusion The expression of serum AMH level in patients with ovarian endometriosis is low,and it is closely related to the age,course of disease,history of dysmenorrhea and the location of the lesion.Laparoscopic ovarian cystectomy may reduce ovarian reserve capacity in patients with ovarian endometriosis.

Expression and research of MALAT1 in endometriosis / 临床检验杂志

Objective To investigate the expression of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in endometriosis (EMS) and its diagnostic value.Methods The information of EMS gene expression was collected from Gene-Cloud of Biotechnology Information (GCBI) and analyzed,in which MALAT1 gene was screened out accordingly.The total RNAs were extracted from tissues and serum samples of the patients with ovarian endometriosis and non-endometriosis and the expression of MALAT1 was detected by real-time quantitative PCR.The correlation between MALAT1 expression level and menstrual cycle was analyzed.The differential diagnostic efficacy of serum MALAT1 levels was analyzed by receiver operating characteristic (ROC) curve.Results Compared with the non-EMS group the expression of MAL4T1 gene was down-regulated by 1.35-fold (t =-3.27,P ＜ 0.01) in EMS group according to gene information analysis of GCBI.The relative expression levels of MALAT1 in ectopic and eutopic endometrium of patients with ovary endometriosis (0.41 ±0.18 and 0.61 ± 0.12) were significantly lower than those in non-endometriosis patients (1.05 ±-0.34,t =5.87 and 4.48,P ＜ 0.01).However,the expression level of MALAT1 was not related with menstrual cycle of the patients with ovarian endometriosis and non-endometriosis (t =1.54 and 1.52,P ＞ 0.05).The expression of MALAT1 in ectopic ovarian cysts was significantly lower than that in eutopic endometrium of ovary endometriosis (t =3.77,P ＜ 0.01).The relative expression of serum MALAT1 in ovary endometriosis (0.60 ±0.18) was significantly lower than that in non-endometriosis (1.05 ± 0.32,t =5.18,P ＜ 0.01).The area under the curve (AUCsOc) was 0.88.When the cut-off value of serum MALAT1 level was set as 0.74,the sensitivity and specificity of expression level of MALAT1 were 82.4％ and 92％ respectively,and Youden's index was 74.4％.Conclusion Low expression of MALAT1 in endometriosis may be related with occurrence and development of endometriosis.Serum MALAT1 level may have certain differential diagnostic value for EMS.

Expression of miR23b and Sp1 in ovarian endometriosis and their clinic significance / 中南大学学报(医学版)

Objective:To investigate the expressions of miR23b and Sp1 in ovarian endometriosis and their clinic significance.Methods:qPCR was used to detect the expression of miR23b and Sp1 mRNA in paired ectopic/eutopic and normal endometrium.Immunohistochemistry and Western bolt were used to determine the expression and distribution of Sp1 in paired ectopic/eutopic and normal endometrium.The association ofmiR23b and Sp1 with the endometriosis was analyzed.Results:MiR23b mRNA expression in paired ectopic/eutopic and normal endometrium was gradually increased (P＜0.05).Sp1 protein mainly distributed in the nucleus of endometrial glandular epithelial and stromal cells,with a little or without expression in cytoplasm.Spl mRNA and protein expression in paired ectopic/eutopic and normal endometrium was gradually reduced (P＜0.05).Pearson correlation analysis showed that miR23b was negatively correlated with Sp 1 (r=-0.526,P＜0.05).Conclusion:MiR23b and Sp1 are involved in the pathogenesis of ovarian endometriosis,which may facilitate the formation of ectopic lesions.

Clinical Effect of Laparoscopy Combined with Gestrinone in Treatment of Ovarian Endometriosis Cyst and the Prognosis of Patients / 昆明医科大学学报

Objective To study clinical effect of laparoscopy combined with gestrinone in treatment of ovarian endometriosis cyst and the prognoisi of patients. Methods A randomized, controlled, prospective study was used in this study, 78 patients with ovarian endometriosis cyst were selected in Sichuan province panzhihua city miyi people's hospital from august 2012 to august 2014, and were randomly divided into observation group and control group, 39 patients in each group. Patients in the observation group were treated with laparoscopy combined with gestrinone (2.5 mg/time, two times per week, for 6 months) intervention; patients in the control group were treated with laparoscopic intervention. After six months, the postoperative serum FSH (Follicle Stmi Ulating Hormone, FSH), Estradiol (E2) and Estradiol levels, ovarian biggest plane average diameter (D), the level of MMP-9 and TIMP -1 level, pregnancy outcome of two groups were compared and the outcome and the recurrence rate 18 months after treatment were followed up. Results Six months after treatment, the E2 and FSH levels in the observation group were better than control group, with statistically significant difference (P2 cm, the postoperative ovarian shrink rate was 51.28% in the observation group; there were 5 patients of D≤2 cm, 34 patients of D>2 cm ovarian shrink ratio was 12.82% in the control group, the ovarian shrink ratio of observation group was obviously higher than control group, with statistically significant difference (P<0.01) . Follow-up for 18 months, the recurrence rate was 5.13%in the observation group, which was significantly lower than thatin the control group (25.64%), with statistically significant difference (P<0.05);the pregnancy rate was 66.66%and 30.77%in the Observation group and control group, respectively, the difference had statistical significance (P<0.01) . Conclusion Laparoscopic surgery combined with gestrinone can protect ovarian function of patients with ovarian endometriosis cyst, improve pregnancy outcomes, and reduce recurrence rate, and has good clinical value.

Ultrasound-guided injection of sclerosant for the treatment of ovarian endometriosis cysts:therapeutic comparison between different sclerosants in 86 cases / 介入放射学杂志

Objective To compare the curative effects of CT-guided ethanol injection and lauromacrogol injection into the sac cavity in treating ovarian endometriosis cysts. Methods A total of 86 patients with ovarian endometriosis cyst were enrolled in this study. The patients were divided into ethanol group (n=44) and lauromacrogol group (n=42). Under CT guidance, injections of ethanol or lauromacrogol into the sac cavity of ovarian endometriosis cysts were respectively performed for the patients of both groups. The patients were followed up for six months, and the curative effects and the complications were analyzed. Results Six months after the treatment, the cure rates of ethanol group and lauromacrogol group were 95.50%and 92.86%respectively, and no statistically significant difference in cure rate existed between the two groups (P>0.05). The preoperative serum CA125 levels of the ethanol group and lauromacrogol group were (48.42±23.68)μg/L and(49.21±22.83) μg/L respectively, and the post operative ones were (23.56±5.89) μg/L and (25.49± 6.10) μg/L respectively; the differences between the preoperative data and the postoperative data were statistically significant in both groups (P0.05). The incidence of postoperative complications in the lauromacrogol group was obviously lower than that in the ethanol group (P<0.05). The cure time in the ethanol group was shorter than that in the lauromacrogol group, although the difference was not significant after six months. Conclusion For the treatment of ovarian endometriosis cysts, CT-guided lauromacrogol injection into the sac cavity has reliable curative effect. Compared to ethanol injection, injection of lauromacrogol is safer and has fewer adverse reactions. Therefore, this technique should be recommended in clinical practice. Serum CA125 can be used as an indicator for the evaluation of curative effect.

The expression of Twist and E -cadherin and its clinical significance in ovarian endometriosis / 预防医学

Objective To know the expression and clinical significance of Twist1,Twist2 and E -cadherin in ovarian endometrium.Methods Immunohistochemistry was used to detect the expression of Twist1,Twist2 and E -cadherin in tissues of ovarian endometrium (EMs I -II,n =24;EMs III -IV,n =30)andnormal endometriums without endometriosis (Control,n =24).Results The expression levels of Twist1,Twist2 were significantly higher in EMs I -II (4.25 ±0.79, 3.83 ±0.96 respectively)and EMs III -IV (4.67 ±0.88,4.30 ±0.95 respectively)while the values of the control group were 3.50 ±0.83,3.54 ±0.88 respectively(both P <0.05),and the group of EMs III -IV had a higher expression of Twist2 (4.30 ±0.95)than that in EMs I -II (3.83 ±0.96)(P <0.05 ).At the same time,the expression of E -cadherin were significantly lower in EMs I -II (3.79 ±0.98)and EMs III -IV (3.57 ±0.73)than the control (4.54 ± 0.93)(P <0.05).The expression of Twist1 and Twist2 was negatively related to that of E -cadherin respectively (both P<0.05),while the expression of Twist1 was positively related to that of Twist2 (P <0.05).Conclusion Twist1,Twist2 and E -cadherin are closely related to the prevalence of endometriosis,while the ability of invasion and metastasis may be associated with the high expression of Twist1 and Twist2,as well as the low expression of E -cadherin.

Correlation study of lesion anatomical characteristics and pain symptoms in patients of ovarian endometriosis cyst / 局解手术学杂志

s:Objective To explore the anatomical distribution characteristics of pelvic endometriosis lesion, size of the cyst, tissue ad-hesion degree and the correlation with the pain symptoms in patients with ovarian endometriosis cyst. Methods 342 cases of patients with o-varian endometriosis cyst who has underwent gynecologic laparoscopic surgical treatment in our hospital were selected as the research objects. According to the pain symptoms, they were divided into the pain group (195 cases) and the painless group (147 cases). The influence of cyst growth area and size on the pain symptoms were compared, and whether there were cyst adhesion and the relationship between adhesion area and pain were analyzed. Results The operation time of pain group was longer. The average operation time was 81. 2 min in pain group while it was 62. 1 min in painless group. The bleeding volum was 74. 3 mL in pain group which was higher than 56. 2 mL in the painless group. The average diameter of cyst was 11. 26 cm in the Pain group, and it was 6. 10 cm painless group. Rate of adhesions in patients of pain group was significantly higher than that of the painless group. Adhesion occured most frequently in ovary, followed by the fallopian tubes. Conclusion Pain symptoms have a close relation with cyst diameter and degree of surrounding tissue adhesion. As the cyst diameter get larger and the surrounding tissue adhesions grow broader, the pain symptoms would be more significant in patients .

Biological characteristics of eutopic endometrial stromal cells in ovarian endometriosis / 中国综合临床

ObjectiveTo investigate eutopic endometrial stromal cells' ability of proliferation,apoptosis and invasion in ( ovarian endometriosis,OEMs).Methods Culture and identify eutopic endometrial stromal cells in 32 cases of patients with OEMs and 32 cases of patients with benign teratoma.Apply methyl thiazolyl tetrazolium methods,flow cytometric and transwell methods to detect these cells' capacity of proliferation,apoptosis and invasion.ResultsEutopic endometrial stromal cells were cultured successfully and their purity was more than 90％.The zero hour's absorbance of OEMs group was similar with control group (0.127 ±0.013vs 0.129 ±0.008,P ＞ 0.05).The growth of 24 and 48 hour's absorbance of OEMs group was significantly higher than control group (24 h -0 h:0.148 ±0.020 vs 0.048 ±0.008,t =26.066;48 h -24 h:0.397 ±0.029vs 0.119 ±0.022,t =42.544,P ＜0.01 ).The apoptosis rate of eutopic endometrial stromal cells in OEMs group was (26.430 ± 3.789 )％ and ( 35.571 ± 4.485 ) ％ in control group,which reached statistical difference ( t =- 8.808,P ＜0.01 ).After the eutopic endometrial stromal cells got through the small room,the absorbance in OEMs group(0.950 ± 0.014) was significantly higher than control group (0.653 ± 0.028 ) ( t =52.947,P ＜0.01 ).ConclusionThe proliferation and invasion capacity of eutopic endometrial stromal cell in OEMs group was more powerful than control group,however the apoptosis ability of this cell in OEMs group was weaker than control group.The change of biological characteristics of eutopic endometrial stromal cells of OEMs might be involved in the occurrance and development of OEMs.

Expression and clinical significance of MIF in the ectopic endometrium and eutopic endometrium of ovarian endometriosis patients / 中国综合临床

Objective To investigate the significance of macrophage migration inhibitory factor(MIF) in ovarian endometriosis (OEms).Methods MIF of ectopic endometriumeutopic endometrium in OEms and endometrium in non-endometriosis (30 cases in every group ) was detected by Elivision TM plus immunohistochemical.Quantitative images analytical system was performed with computer to analyze the mean absorbance(A) of MIF.Results The A of MIF in ectopic and eutopic endometrium of OEms and the normal control was respectively ( 0.180 ± 0.013 ),( 0.158 ± 0.022 ) and ( 0.143 ± 0.029 ),there was statistical significance between groups ( F =47.676,P ＜ 0.001 ).The expression of MIF in proliferative phase of eutopic endometrium of OEms was(0.157 ±0.018),extremely stronger than that in the same phase of the normal control (0.146 ± 0.029 ) ( t =2.656,P =0.009 ) ; and MIF in secretory phase of eutopic endometrium of OEms was (0.160±0.028),obviously higher than that in the same phase of the normal control(0.137 ±0.030) (t =3.059,P =0.003).Conclusion The MIF may play a significant role in the pathogenesis and development of ovarian endometriosis.

Expression and clinical significance of HIF-1 in the ectopic endometrium and eutopic endometrium of ovarian endometriosis patients / 中国综合临床

Objective To investigate the significance of hypoxia inducible factor-1(HIF-1) expression in ovarian endometriosis (Oems). Methods Elivision Tm plus Immunohistochemical and Stereology methods were used to detect HIF-1 expression in 30 cases of ectopic endometrium, 30 cases of eutopic endometrium in ovarian endometriosis and 30 cases of endometrium in ovarian teratoma as the normal control. Quantitative images analysis was performed with the aid of computer to collect and analyze the mean optical density (MOD) of HIF-1 expression. Results The MOD values of HIF-1 in ectopic and eutopic endometrium of Oems and the normal control were 0. 077 ± 0. 014, 0. 070 ± 0. 013 and 0. 061 ± 0. 007 respectively, which showed significantly differences between each other groups(F = 37. 738, P ＜ 0. 01 ＝. HIF-1 expression in proliferative phase (0.076 ±0.007) of eutopic endometrium of Oems was significantly higher than that in secretary phase (0. 059 ±0. 014) (t = 6. 918 ,P ＜0. 01 ＝; which was also significantly higher than that of the normal control in the same phase (0.060±0.007) (t=-12.724,P ＜0.01 ＝.Conclusion HIF-1 may play an important role in the pathogenesis and development of Oems.

Clinical value of transvaginal color Doppler ultrasound in the detection of blood flow changes within the ovarian stromal artery in patients with ovarian endometriosis / 复旦学报（医学版）

Objective To explore the clinical value of transvaginal color Doppler ultrasound(TV-CDS)in the detection of blood flow changes within the ovarian stromal artery in patients with ovarian endometriosis.Methods Blood flow indices within the ovarian stromal artery were measured by TV-CDS in 60 patients and60 normal controls.Results In ovarian endometriosis group,TV-CDS examination showed the color signal pattern was dot-like with high-resistance ovarian stromal arterial flow which manifested significant higher resistance index(RI),pulsatility index(PI)and systolic/diastolic(S/D)ratio than those in normal group(P<0.01).Analysis on clinicopathologic data showed that cystic history and diameter were risk factors affecting the absence of ovarian stromal blood signal,while cystic history,diameter and category were associated with the significant difference of blood flow display area(P<0.05).Conclusions TV-CDS can be used as a non-invasive,convenient and sensitive method for assessing blood flow changes within the ovarian stromal artery,indicating ovarian interstitial damage as well as pathological conditions of ovarian endometriosis that contributes to clinical diagnosis and treatment.

Ovarian endometriosis and the risk of malignancy / 复旦学报（医学版）

Objective To explore the clinical and pathological characteristics of ovarian endometriosis and malignant cases, and to improve our recognition of this disease. Methods A total of 1 289 cases of ovarian endometriosis were divided into two groups: the benign group (1 275 cases)and the malignant group (14 cases). They were analyzed on: dysmenorrhea, infertility, features of ultrasound examination,site of tumour,pathological types and complications. Results Malignancy arising from ovarian endometriosis was 1.09%. As far as degree of dysmenorrhea, size of cyst >10 cm, CA125 >500 U/L, features of ultrasound were concerned, difference between the two groups was statistically significant. Conclusions In the present study, the malignant rate of ovarian endometriosis was about 1%. Malignancy should be considered seriously when the following situations occured: change in the degree of dysmenorrhea, size of cyst larger than 10 cm, CA125 higher than 500 U/L, mamilla observed by ultrasound examination.

The Expression of P450arom in Human Ovarian Endometriosis and the Relation Ship with its Estrogen Aabnormal Synthesis Locally / 医学研究杂志

Objective To study the expression of P450arom(P450A)protein and mRNA in human ovarian endometriosis and normal endometrium and the relationship with its local estrogen abnormal synthesis.Methods PT-PCR was used to assess P450arom messenger RNA(mRNA)expression of 45 ovarian endometriosis and 35 normal eutopic endometrium;immunohistochemical assay was performed to locate and examin the protein expression of P450arom in the above cases.Results P450A mRNA level was higher in the ectopic endometrium than that in eutopic endometrium(P

Laparoscopy versus laparotomy for the treatment of ovarian endometriosis cysts / 中国微创外科杂志

Objective To compare effects between laparoscopy and laparotomy for the treament of ovarian endometriosis cysts and to investigate the value of laparoscopy in the treatment of ovarian endometriosis cysts. Methods We retrospectively analyzed 144 cases of ovarian endometriosis cysts,92 of which underwent laparoscopic operations(Laparoscopic Group) and 52 of which received open operations(Open Group).All the cases were followed for 4 months ~ 5 years.Results The operation time,postoperative hospital stay,and intraoperative blood loss were 69?41.8 min,3.5?1.0 d,and 55?12.0 ml in the Laparoscopic Group,respectively,and 137?54.3 min,8.7?3.5 d,and 178?105.9 ml in the Open Group,respectively,with significant differences between the two groups(t=-8.402,-11.048,and-13.350;P=0.000).There was no significant difference in the rate of abdominal pain relief between the Laparoscopic Group(66.0%,35/53) and the Open Group(52.8%,19/36)(?~2=1.580,(P=0.209)).The recurrent rate was 19.6%(18/92) in the Laparoscopic Group and 19.2%(10/52) in the Open Group,without significant difference between the two groups(?~2=0.002,P=0.961). Conclusions Laparoscopic surgery gives similar efficacy to open surgery in the treatment of ovarian endometriosis cysts.Laparoscopic surgery can be used as the first choice in treating ovarian endometriosis cysts because of its minimally invasive characteristics.

Mid-Long Term Outcomes of 209 Cases of Laparoscopic Treatment of Ovarian Endometriosis Cysts / 中国微创外科杂志

Objective To evaluate the mid-long term effects of laparoscopic treatment of ovarian endometriosis cysts.Methods Clinical data of 209 cases of ovarian endometriosis cysts treated by laparoscopic operation from January 2002 to December 2005 were retrospectively analyzed.All the patients were followed for at least 12 months(12-54 months).There were 115 cases of unilateral ovarian cyst enucleation,62 cases of bilateral enucleation,11 cases of unilateral adnexectomy,and 21 cases of unilateral adnexectomy combined with contralateral cyst enucleation.Oral gestrinone was administrated in patients without childbearing intentions,while in patients demanding a child,no drug was given and an early pregnancy was encouraged.Results Conversions to open surgery were required in 7 cases.No complications occurred.Ovarian endometriosis cysts recurred in 17 cases(8.1%),including 7 cases of stage Ⅲendometriosis and 10 cases of stage Ⅳ endometriosis.Of the 35 cases of infertility,intrauterine pregnancy was obtained in 16 cases,with a pregnancy rate of 45.7%.The pregnancy occurred at 4-29 months after operation(within 2 years in 10 cases).Of the 157 cases of dysmenorrhea,a complete relief was achieved in 95 cases(60.5%)and an improvement was obtained in 62 cases(39.5%).Conclusions Laparoscopic treatment is suitable for all stages of ovarian endometriosis cysts.Postoperative drug administration and long-term follow-up are necessary to lower the recurrence rate.