Transvaginal Versus Conventional Laparoscopy for Ovarian Dermoid Cysts A Matched Cohort Study

OBJECTIVE: To compare transvaginal versus conventional laparoscopy for dermoid cysts. STUDY DESIGN: We retrospectively analyzed all consecutive patients with dermoid cysts who underwent transvaginal (n=219) or conventional (n=245) laparoscopy from 2007-2013 at our institution. Each group of patients was matched (1:1 ratio) for age, body mass index, previous surgical history, cyst diameter, bilaterality, and cystectomy/oophorectomy. Surgical outcomes were compared between the 2 groups. RESULTS: Overall, 165 pairs were matched. Operating times (expressed as median [inter quartile range]) (64 [49-88] vs. 70 [54-93] minutes, p = 0.011), estimated blood loss (100 [70-200] vs. 90 [70-130] mL, p = 0.245), and postoperative hospital stay (1 [1-1] vs. 1 [1-2] days, p = 0.029) were similar between groups. Postsurgical pain scores after 3 (expressed as mean [standard deviation]) (3.52 [1.27] vs. 3.94 [1.05], p<0.001), 8 (2.88 [0.92] vs. 3.60 [1.01], p<0.001), and 16 (2.81 [0.97] vs. 3.38 [0.93], p =0.005) hours were similar but statistically significant between groups. Perioperative complications occurred in 2 and 4 patients in the transvaginal and conventional groups, respectively. CONCLUSION: Transvaginal laparoscopy shows feasibility and efficacy similar to those of conventional laparoscopy for management of dermoid cysts.