Drilling: medical indications and surgical technique

Hueb, Cristina Kallás; Júnior, João Antônio Dias Dias; Abrão, Maurício Simões; Filho, Elias Kallás

doi:10.1590/1806-9282.61.06.530

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…Although the drug treatment of PCOS could improve the clinical symptoms, there are many deficiencies, such as inducing the endometrium thinning, increasing the risk of thrombosis and damaging the liver function of patients with hepatitis B [15–17]. Surgical treatments mainly include laparoscopic ovary perforation and ovary wedge resection [18,19]. The biggest side effects of surgical treatment are the destruction of the ovary and the depletion of the reserve follicles, which lead to the premature ovarian failure in many patients [18,20].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatments mainly include laparoscopic ovary perforation and ovary wedge resection [18,19]. The biggest side effects of surgical treatment are the destruction of the ovary and the depletion of the reserve follicles, which lead to the premature ovarian failure in many patients [18,20]. Therefore, the surgical treatment of PCOS is rarely used by clinicians.…”

Section: Discussionmentioning

confidence: 99%

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Total flavonoids extracted from Nervilia Fordii function in polycystic ovary syndrome through IL-6 mediated JAK2/STAT3 signaling pathway

Zhou

Liu

et al. 2019

Bioscience Reports

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Large doses of flavonoids could cure many diseases with no serious side effects. However, the role of flavonoids in the treatment of polycystic ovary syndrome (PCOS) has not been reported. Therefore, total flavonoids extracted from Nervilia Fordii were selected to explore its therapeutic efficiency in PCOS. PCOS rat model was constructed to explore the role of total flavonoids in the treatment of PCOS. ELISA was used to assess the changes of ovulation function under the treatment of total flavonoids with or without exogenous interleukin-6 (IL-6). Western blot, real-time PCR and immunohistochemistry were carried out to assess the related molecular mechanisms. We explored that total flavonoids obviously increased the serum levels of follicle-stimulating hormone (FSH), and sharply decreased the serum levels of luteinizing hormone (LH), testosterone (T) and insulin (INS) in the PCOS-IR rats via partly inhibiting the activation of JAK2/STAT3 pathway, partially up-regulating the IL-6 expression and partially down-regulating the suppressor of cytokine signaling 3 (SOCS3) expression in ovaries of PCOS rats. The effect of total flavonoids on estrous cycles, serum levels of FSH, LH, T and INS were partially attenuated by IL-6 in PCOS rat model. Moreover, IL-6 significantly reversed the effect of total flavonoids on the phosphorylation of JAK2/STAT3, the expression of IL-6 and SOCS3 in ovaries of PCOS rats. Total flavonoids extracted from Nervilia Fordii might induce the expression of IL-6 in ovary and act as a potential therapeutic drug for the treatment of PCOS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Total flavonoids extracted from Nervilia Fordii function in polycystic ovary syndrome through IL-6 mediated JAK2/STAT3 signaling pathway

Zhou

Liu

et al. 2019

Bioscience Reports

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“…A review about the role of laparoscopic ovarian drilling (LOD) in PCOS women drew attention to its benefits in patients with CC resistance, BMI < 30 kg/m 2 and preoperative LH above 10 IU/L. In addition, the authors described that the performance of 5 to 10 perforations on the surface of each ovary using monopolar energy was the preferred surgical technique [86]. LOD may be considered in infertile PCOS women resistant to CC or letrozole, especially if laparoscopy is indicated by another reason such as tubal patency assessment or salpingectomy.…”

Section: Laparoscopic Ovarian Drillingmentioning

confidence: 99%

Polycystic ovary syndrome throughout a woman’s life

Bellver

Rodríguez-Tabernero

Robles

et al. 2017

J Assist Reprod Genet

119

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Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women and the main cause of infertility due to anovulation. However, this syndrome spans the lives of women affecting them from in-utero life until death, leading to several health risks that can impair quality of life and increase morbidity and mortality rates. Fetal programming may represent the beginning of the condition characterized by hyperandrogenism and insulin resistance which leads to a series of medical consequences in adolescence, adulthood, and old age. Menstrual and fertility problems evolve into metabolic complications as age advances. An early and precise diagnosis is important for an adequate management of PCOS, especially at the extreme ends of the reproductive lifespan. However, many different phenotypes are included under the same condition, being important to look at these different phenotypes separately, as they may require different treatments and have different consequences. In this way, PCOS exhibits a great metabolic complexity and its diagnosis needs to be revised once again and adapted to recent data obtained by new technologies. According to the current medical literature, lifestyle therapy constitutes the first step in the management, especially when excess body weight is associated. Pharmacotherapy is frequently used to treat the most predominant manifestations in each age group, such as irregular menses and hirsutism in adolescence, fertility problems in adulthood, and metabolic problems and risk of cancer in old age. Close surveillance is mandatory in each stage of life to avoid health risks which may also affect the offspring, since fetal and post-natal complications seem to be increased in PCOS women.

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“…No caso de pacientes resistentes ao efeito dos medicamentos, o tratamento cirúrgico por laparoscopia com drilling (perfuração) é uma alternativa para indução da ovulação. A perfuração laparoscópica é uma cirurgia minimamente invasiva na qual os ovários são tratados com pequenas perfurações de calor ou laser (Hueb et al, 2015). A técnica utilizada é a realização de 5 a 10 perfurações na superfície do ovário, bilateralmente, usando energia monopolar (Hueb et al, 2015).…”

Section: Tratamentounclassified

Síndrome de ovários policísticos (SOP), fisiopatologia e tratamento, uma revisão

Alves

Donne²,

Romano³

et al. 2022

RSD

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A síndrome dos ovários policísticos é uma patologia de etiologia multifatorial e uma das principais causas de infertilidade feminina mundialmente. Além de alterações na fisiologia reprodutiva, como ciclos menstruais irregulares, anovulação, hiperandrogenismo e presença de múltiplos cistos no ovário, também ocorrem alterações metabólicas capazes de afetar a qualidade de vida e a sobrevida de mulheres portadoras da síndrome. O comprometimento endócrino atrelado à síndrome dos ovários policísticos ocorre devido ao desenvolvimento de síndrome metabólica, condição caracterizada por tolerância à glicose diminuída, dislipidemia e hipertensão. Contudo, a manifestação dos sintomas associados à síndrome dos ovários policísticos depende da interação entre fatores genéticos, epigenéticos, estilo de vida e hábitos alimentares. A inter-relação entre esses fatores resulta na diversidade fenotípica apresentada por mulheres portadoras da síndrome. Ou seja, as manifestações clínicas e a gravidade sintomática variam entre as mulheres portadoras, de forma que o tratamento é individualizado para cada paciente. O manejo terapêutico da síndrome é voltado ao alívio sintomático e indução da ovulação, uma vez que ainda não existe um tratamento curativo. Essa revisão narrativa objetiva evidenciar os principais aspectos clínicos, endócrinos e metabólicos da síndrome dos ovários policísticos, uma das principais causas de infertilidade feminina.

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Drilling: medical indications and surgical technique

Abstract: Hueb CK et al. 530rev assoC Med Bras 2015; 61(6):530-535

Cited by 11 publications

References 26 publications

Total flavonoids extracted from Nervilia Fordii function in polycystic ovary syndrome through IL-6 mediated JAK2/STAT3 signaling pathway

Total flavonoids extracted from Nervilia Fordii function in polycystic ovary syndrome through IL-6 mediated JAK2/STAT3 signaling pathway

Polycystic ovary syndrome throughout a woman’s life

Síndrome de ovários policísticos (SOP), fisiopatologia e tratamento, uma revisão

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