A comparison of follicular response of ovaries to ovulation induction after laparoscopic ovarian cystectomy or fenestration and coagulation versus normal ovaries in patients with endometrioma

Ravanbakhsh, Romina; Parsanezhad, Mohammad Ebrahim; Alborzi, Mahshid; Alborzi, Saeed; Dehbashi, Sanaz

doi:10.1016/j.fertnstert.2006.11.134

Cited by 70 publications

(47 citation statements)

References 15 publications

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“…Fenestration and ablation or laser vaporization of endometriomas without excision of the pseudocapsule is associated with a significantly increased risk of cyst recurrence. Alborzi et al (16) found that laparoscopic ovarian cystectomy was associated with better outcomes in pregnancy rates and relief of pain than fenestration and coagulation of endometriomas and had a lower rate of reoperation, even in larger cysts. As a result, they recommend that cystectomy of endometriomas is a better option than fenestration and coagulation, especially in patients with infertility and pelvic pain.…”

Section: Fenestration and Ablation (Fulguration Or Vaporization)mentioning

confidence: 99%

Ovarian cystectomy in endometriomas: Combined approach

Ünlü

Yıldırım

2014

J Turkish German Gynecol Assoc

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Endometrioma is one of the most frequent adnexal masses in the premenopausal population, but the recommended treatment is still a subject of debate. Medical therapy is inefficient and can not be recommended in the management of ovarian endometriomas. The general consensus is that ovarian endometriomas larger than 4 cm should be removed, both to reduce pain and to improve spontaneous conception rates. The removal of ovarian endometriomas can be difficult, as the capsule is often densely adherent. While the surgical treatment of choice is surgical laparoscopy, for conservative treatment, the preferred method is modified combined cystectomy. Cystectomy can be destructive for the ovary, whereas ablation may be incomplete, with a greater risk of recurrence. To the best of our knowledge, the modified combined technique seems to be more efficient in the treatment of endometriomas. (J Turk Ger Gynecol Assoc 2014; 15: 177-89) Key words: Endometrioma, laparoscopy, cystectomy, combined technique Received: 25 August, 2014 Accepted: 29 August, 2014 Ovarian cystectomy in endometriomas: Combined approach This article will be credited by TMA within the scope of CME/CPD.

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Section: Fenestration and Ablation (Fulguration Or Vaporization)mentioning

confidence: 99%

Ovarian cystectomy in endometriomas: Combined approach

Ünlü

Yıldırım

2014

J Turkish German Gynecol Assoc

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“…Most of these were subsequently excluded from our final review for the following reasons: 9 were animal studies; 11 had used different comparisons; 57 discussed different topics, and 129 were not RCTs. Thus, 7 trials were deemed eligible for inclusion in the meta-analysis [16,17,18,19,20,21,22]. …”

Section: Resultsmentioning

confidence: 99%

“…Across all seven studies, the treatment groups were comparable for patient age. Four of the trials investigated the outcome of laparoscopic ovarian cystectomy versus fenestration and coagulation for ovarian endometriomas [16,17,18,19]. In one of these studies, patients were randomized to 1 of 3 groups: cystectomy, fenestration and coagulation, or both cystectomy and fenestration/coagulation (patients in this group had bilateral endometriomas) [17].…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Ovarian Cystectomy versus Fenestration/Coagulation or Laser Vaporization for the Treatment of Endometriomas: A Meta-Analysis of Randomized Controlled Trials

Dan

Lin²

2013

Gynecol Obstet Invest

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Aim: To compare outcomes after laparoscopic ovarian cystectomy versus fenestration/coagulation or laser ablation for the treatment of endometriomas. Methods: Studies were identified by searching the PubMed, EMBASE, SCOPUS, and Cochrane Central Register of Controlled Trials databases using the terms ovarian, endometrioma or endometriosis, cystectomy, fenestration, coagulation, laser, and ablation or vaporization. The outcomes of interest were recurrence of signs/symptoms and endometrioma, reoperation, pregnancy, and ovarian reserve. Results: Seven studies were included. The risk of recurrence of signs/symptoms after surgery was significantly lower for laparoscopic cystectomy compared with fenestration/coagulation [risk ratio (RR): 0.29; 95% CI: 0.15-0.55; I² = 0%; p < 0.001], as was the risk of recurrence compared with fenestration/coagulation (RR: 0.50; 95% CI: 0.26-0.97; I² = 0%; p = 0.04) and laser vaporization (RR: 0.33; 95% CI: 0.12-0.88; I² = 0%; p = 0.03). The risk of pregnancy was significantly higher for cystectomy compared with fenestration/coagulation (RR: 2.64; 95% CI: 1.49-4.69; I² = 0%; p < 0.001), but not laser vaporization (RR: 0.92; 95% CI: 0.30-2.80; p = 0.89). There were inadequate data for the meta-analysis of ovarian reserve. Conclusions: Our findings suggest that cystectomy provides better outcomes than fenestration/coagulation or laser ablation regarding recurrence of symptoms and endometrioma as well as pregnancy rate (fenestration/coagulation only). Further studies are needed to clarify the effect of these surgical approaches on ovarian reserve.

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“…Bu çalış-maların çoğunda da kistektomi yönteminin kist rekürrensi, ovulasyon indüksiyonu ile elde edilen folikül sayısı ve gebelik oranlarına etkisi araştırılmıştır. [18,19,20] Literatürde ovaryan rezervin Doppler akım formlarıyla değerlendirildiği tek bir çalış-ma mevcut olup bu çalışmada da ovaryan volümün cerrahi işlem sonrası anlamlı derecede azaldığı (p:0,002) gösterilmiştir [21]. Bizim çalışmamızda da benzer şekilde ovaryan volüm anlamlı derecede azalmış olarak bulundu (p<0,001).…”

Section: Discussionunclassified

The Effect of the Ovarian Endometrioma Surgery on Ovarian Reserve and Ovarian Blood Flow

Yılmaz¹,

Uysal²,

Önoglu³

et al. 2015

Ann Clin Anal Med

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ÖzetAmaç: Laparaskopik endometriosis cerrahisinin ovaryan rezerv ve ovaryan kan akım parametreleri üzerine olan etkilerini araştırmak. Gereç ve Yöntem: Üçüncü basamak eğitim ve araştırma hastanesinde endometrioma nedeniyle laparaskopik cerrahi uygulanan 26 hasta prospektif olarak değerlendirildi. Olgulara cerrahi işlem öncesi ve sonrası adet periyodunun 3üncü günü FSH, LH ve E2 bakıldı. Operasyon öncesi ve sonrası olguların ultrasonografik olarak kist volümü, over volümü ve ovaryan arter rezistif indeks'i Doppler ultrasonografi ile değerlendirildi. Bulgular: Çalışma gurubundaki 26 hastanın yaş ortalaması 25,6 ± 4,5 (20-36 yaş) idi. Operasyon öncesi ve sonrası üçüncü gün bakılan hormonal değerler karşılaştırıldığında sırasıyla FSH (p: 0,455), LH (p: 0,672), değerlerinde bir değişiklik izlenmezken, E2 (p: 0,024) değerleri-nin anlamlı olarak azaldığı görüldü. Cerrahi sonrası ovaryan volüm anlamlı bir şekilde azalırken (p: 0,001), bu azalışın Ovaryan Arter RI değerlerini (p: 0,587) etkilemediği görüldü. Sonuç: Çalışmamızda ovaryan endometriomaların laparoskopik kistektomisi sonrasında over hacimlerinin anlamlı olarak azaldığını ama bunun, hormon sonuçlarına ve ovaryan arter kan akımlarına bakıldığında over rezervini etkilemediği görüldü. Anahtar KelimelerEndometriosis; Ovaryan Rezerv; Doppler Ultrasonografi Abstract Aim: To investigate the effectiveness of laparoscopic endometriosis surgery on ovarian reserve and ovarian blood flow index. Material and Method: Twenty-six patients were evaluated prospectively whom had laparoscopic surgery due to endometrioma in third care education and research hospital. Before and after surgical procedure all patients FSH, LH and E2 levels were measured in their 3rd menstrual period day. Periodically cysts and ovarian volume as well as ovarian artery resistive index measured by using transvaginal Doppler sonography. Results: Twenty-six patients' mean age was 25, 6 ± 4, 5 (20-36 years). When the compared to changes of preoperative and postoperative values of hormonal parameters FSH (p: 0,455) and LH (p: 0,672) were insignificant and E2 (p: 0,024) was significant respectively. While ovarian volume was decreasing significantly (p: 0,001), Ovarian Artery RI parameter was not changed (p: 0,587). Discussion: Our study was showed that while laparoscopic surgical treatment of ovarian endometriomas significantly decrease ovarian volume, but hormonal parameters and ovarian blood flow were not affected.

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A comparison of follicular response of ovaries to ovulation induction after laparoscopic ovarian cystectomy or fenestration and coagulation versus normal ovaries in patients with endometrioma

Cited by 70 publications

References 15 publications

Ovarian cystectomy in endometriomas: Combined approach

Ovarian cystectomy in endometriomas: Combined approach

Laparoscopic Ovarian Cystectomy versus Fenestration/Coagulation or Laser Vaporization for the Treatment of Endometriomas: A Meta-Analysis of Randomized Controlled Trials

The Effect of the Ovarian Endometrioma Surgery on Ovarian Reserve and Ovarian Blood Flow

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