Use of Oxidized Regenerated Cellulose (ORC) in treatment of ovarian endometriomas to prevent recurrence and preserve ovarian reserve

Abstract
Background: Oxidized Regenerated Cellulose (ORC) is used in the treatment of Endometriosis to eliminate or postpone endometriomas’ recurrence and to preserve ovarian reserve subsequently increasing pregnancy rate. The aim of this research was to evaluate the benefit of ORC in surgical management of ovarian endometriomas to reduce the rate of recurrence while preserving ovarian reserve. Methods: This prospective randomized controlled research was carried out on 60 cases, divided into two groups: Group A (drainage and ablation): 30 cases had laparoscopic drainage of ovarian endometrioma with electrocautery of the endometriomal cyst wall. Group B (drainage and ORC): 30 cases had laparoscopic drainage of ovarian endometrioma with insertion of ORC inside the cyst cavity. Results: There was a statistically significant difference according to 3 and 6 months in anti-mullerian hormone (AMH) (ng/ml) and Antral Follicular Count (AFC) being higher in ORC group compared to ablation group while the reduction in AMH (change) was significantly lower in ORC group (P values< 0.001). The recurrence rate of ovarian endometrioma was comparable between both groups. AMH and AFC was significantly associated with the recurrence of ovarian endometrioma 3 and 6 months. Conclusions: ORC reduces effectively the recurrence risk of endometriomas following laparoscopic drainage.