THE MAIN ASPECTS OF THE TREATMENT OF ENDOMETRIOID OVARIAN CYSTS
Cystic ovarian endometriosis is a widely spread genital form of endometriosis. However, there is still no universal opinion about managing women with ovarian endometriosis. There are 3 main treatment trends: surgical, hormonal and combined. Surgical treatment of patients of reproductive age implies preservation of fertility. It is necessary to observe all the principles of microsurgery using attenuated impact of up-to-date surgical energies on ovarian tissue (only damaged areas are enucleated) in order to save ovarian reserve. Medical (hormonal) treatment in case of small endometriomas (up to 3 cm) preserves ovarian and follicular reserve and, subsequently, fertility. Therefore, early diagnosis of endometriosis plays an important role in its treatment. Numerous clinical studies have shown that hormonal therapy, regardless of the choice of the drug, compared to placebo successfully relieves the pain associated with endometriosis (dienogest inhibits expression of nerve growth factor, which is a key mediator in the generation of pain associated with endometriosis), including dysmenorrhea, premenstrual pain, dyspareunia and diffuse pelvic pain.