Hemostasis by Bipolar Coagulation Versus Suture After Surgical Stripping of Bilateral Ovarian Endometriomas: A Randomized Controlled Trial

Ferrero, Simone; Venturini, Pier Luigi; Gillott, David J.; Remorgida, Valentino; Maggiore, Umberto Leone Roberti

doi:10.1016/j.jmig.2012.08.001

Cited by 83 publications

(79 citation statements)

References 36 publications

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“…Ferrero et al showed through a randomized controlled trial that laparoscopic stripping of ovarian endometriotic cyst significantly decreases ovarian reserve [measured by means of serum anti Mullerian hormon (AMH) and basal FSH levels] independent from the method used to obtain hemostasis on the ovarian tissue (bipolar coagulation or suturing). 21 In our study, the suturing technique was used to control bleeding after cystectomy based on this data but postoperative AFC of operated ovaries was shown to be significantly decreased while the postoperative FSH levels were found to be increased. This findings could not confirm whether the damage of residual ovarian tissue caused by suturing or not.…”

Section: Fshmentioning

confidence: 79%

The Effect of Unilateral Endometrioma Excision on Ovarian Reserve

Semiz¹,

Apı²,

Kayatas³

et al. 2015

Turkiye Klinikleri J Gynecol Obst

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M echanisms of infertility associated with endometriosis are controversial. It is hypothesized that endometriosis is associated with overproduction of prostaglandins, metalloproteinases, cytokines, Turkiye Klinikleri J Gynecol Obst 2015;25(2) 71 The Effect of Unilateral Endometrioma Excision on Ovarian Reserve A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To evaluate the effect of laparoscopic cystectomy for endometriomas on ovarian reserve as determined by antral follicle count (AFC) and follicle stimulating hormone (FSH) level. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : In this prospective, observational, operated and non-operated site comparative study, twenty one women between 20-36 ages with previous history of laparoscopic surgery for unilateral ovarian endometriomas greater than 30 mm were called for the evaluation of ovarian reserve at third month. Only first endometrioma removal operations were included. Removal of endometrioma was performed by laparoscopic ovarian tissue-sparing stripping technique. AFC of both ovaries were evaluated on 2-5 day of postoperative third menstrual cycle by independent examiners, blinded to the clinical and surgical history of patients. AFCs of both ovaries were analyzed to compare between operated and non-operated sites. Pre and postoperative FSH levels were recorded also. R Re es su ul lt ts s: : There was statistically significant difference in the mean number of antral follicles in the operated side ovary (2.61±1.24) when compared to the non-operated side ovary (4.23±0.88) (p<0.001). Although a significant difference was found between pre and postoperative FSH levels (6.7±1.8 vs 6.9±1.6, p=0.011), this did not reach to clinical significance. C Co on nc cl lu u--s si io on n: : Our study results suggested that excision of endometriomas might have a negative impact on ovarian reserve as evidenced by a significant postoperative fall in ipsilateral AFC level.K Ke ey y W Wo or rd ds s: : Endometriosis; laparoscopy; follicle stimulating hormone; follicular fluid Ö ÖZ ZE ET T A Am ma aç ç: : Endometriyoma eksizyonu için yapılan laparoskopik kistektominin over rezervi üze-rine etkilerinin antral folikül sayısı (AFS) ve folikül stimülan hormon (FSH) seviyesi açısından değerlendirilmesi. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Prospektif, gözlemsel, opere edilen tarafın opere edilmeyen tarafla karşılaştırıldığı bu çalışmada tek taraflı, 30 mm üzerinde ovarian endometriyoma nedeniyle laparoskopik operasyon geçirme öyküsü olan 20-36 yaş arası 21 kadın, operasyon sonrası 3. ayda çağrıldı. Sadece ilk kez ve laparoskopik stripping yöntemiyle endometriyoma ameliyatı geçirenler çal-ışmaya dâhil edildi. Her iki overin antral folikülleri, hastanın klinik ve operasyon öyküsüne kör bağımsız bir araştırmacı tarafından operasyon sonrası 3. ayda siklusun 2-5. günleri arası değerlendi-rildi. Her iki overin AFS'leri opere olan ve olmayan taraf arasında karşılaştırıldı. Pre ve postoperative FSH düzeyleri kaydedildi. B Bu ul lg gu ul la ar r: : Opere ol...

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Section: Fshmentioning

confidence: 79%

The Effect of Unilateral Endometrioma Excision on Ovarian Reserve

Semiz¹,

Apı²,

Kayatas³

et al. 2015

Turkiye Klinikleri J Gynecol Obst

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“…A prospective longitudinal study of the short-term measurement of serum AMH levels after ovarian surgery demonstrated that the median AMH level was 2.23 ng/ml (95% CI 1.35-3.41 ng/ml) before surgery but decreased to 0.67 ng/ml (95% CI 1.35-3.41 ng/ml) 1 week post-surgery, and then increased to 1.14 ng/ml (95% CI 0.79-2.36 ng/ml) 1 month post-surgery and 1.50 ng/ml (95% CI 0.58-3.26 ng/ml) at 3 months post-surgery, indicating that ovarian reserve is reduced after ovarian surgery, but restored 3 months post-surgery [25] . Another prospective study regarding long-term measurements of serum AMH levels after ovarian surgery demonstrated that there were no changes in AMH levels at 3, 6, and 12 months post-surgery [26] . Therefore, because complete recovery of postoperative ovarian reserve seems to be obtained at 3 months postsurgery, we believe that the timing of AMH measurement at 3 months post-surgery as in this study was appropriate.…”

Section: Discussionmentioning

confidence: 99%

Opportunistic Salpingectomy Does Not Affect Ovarian Reserve or Surgical Outcomes in Patients Undergoing Laparoscopic Myomectomy

Song

Lee²,

Kim³

et al. 2016

Gynecol Obstet Invest

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Objective: To determine whether opportunistic salpingectomy in patients undergoing laparoscopic myomectomy has any deleterious effects on ovarian reserve and surgical risk. Study Design: We performed a retrospective review of patients who had no desire for future child bearing and who were undergoing laparoscopic myomectomy for symptomatic myomas at 4 institutions. Among them, 41 patients concurrently underwent opportunistic salpingectomy (the opportunistic salpingectomy group) and 65 patients did not undergo salpingectomy at the time of laparoscopic myomectomy (the no-salpingectomy group). The primary and secondary outcome measures were change of ovarian reserve determined by the rate of decline in the anti-Müllerian hormone (AMH) level from before surgery to 3 months post-surgery, and surgical outcomes. Results: Baseline characteristics were similar between groups. There were also no differences in surgical outcomes, such as operative time, operative bleeding, hospital stay, or complications between groups. The decline rate in AMH was 18.6% (interquartile range (IQR) 2.6-46.8%) in the opportunistic salpingectomy group and 10.4% (IQR 2.6-46.8%) in the no-salpingectomy group, with no significant difference between groups (p = 0.593). Conclusion: Opportunistic salpingectomy at the time of laparoscopic myomectomy was not associated with negative effects on ovarian reserve or increased surgical risk.

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“…Those haemostatic techniques were also investigated in a randomized controlled trial and no difference was seen between the two haemostatic approaches and pregnancy rate and time to conception [ 31 ]. However, women had a reduced ovarian reserve following ovarian cystectomy irrespective of the method of haemostasis [ 31 ].…”

Section: Managementmentioning

confidence: 99%

Endometrioma and Infertility: Principles and Techniques of Management

Karasu

Ola

2015

Reproductive Surgery in Assisted Conception

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Endometriosis occurs when endometrial tissue is detected outside of the uterus. The prevalence of endometriosis depends on the diagnostic method, but ranges between 25 and 40 % of women [ 1 ]. The relationship of endometriosis to infertility is not always clear-cut. A review of 32 studies by Eskenazi showed that up to 78 % of infertile women had endometriosis [ 2 ]. Similarly, D'Hooghe et al. pooled 13 studies, demonstrating that up to 50 % of previously fertile women had proven endometriosis [ 3 ]. An endometrioma is formed following the invagination of endometriotic deposits on the ovarian cortex, eventually forming what is commonly described as 'chocolate' cysts [ 4 ]. Ovarian endometriomas are found in 17-44 % of women with endometriosis [ 5 , 6 ]. Although the ovaries are the commonest site of endometriomas, there are numerous reports of extra-gonadal chocolate cysts in distant locations like the umbilicus [ 7 , 8 ], brain [ 9 ], liver and other sites [ 10 , 11 ]. These extra-gonadal lesions do not, however, have direct effects on infertility.

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Hemostasis by Bipolar Coagulation Versus Suture After Surgical Stripping of Bilateral Ovarian Endometriomas: A Randomized Controlled Trial

Cited by 83 publications

References 36 publications

The Effect of Unilateral Endometrioma Excision on Ovarian Reserve

The Effect of Unilateral Endometrioma Excision on Ovarian Reserve

Opportunistic Salpingectomy Does Not Affect Ovarian Reserve or Surgical Outcomes in Patients Undergoing Laparoscopic Myomectomy

Endometrioma and Infertility: Principles and Techniques of Management

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