Laparoscopic excision of ovarian cysts: is the stripping technique a tissue-sparing procedure?

Muzii, Ludovico; Bianchi, Antonella; Croce, C. Della; Manci, Natalina; Panici, Pierluigi Benedetti

doi:10.1016/s0015-0282(01)03203-4

Cited by 246 publications

(192 citation statements)

References 17 publications

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“…The tissue surrounding endometriomas often shows morphological alterations that are not present in tissue surrounding benign cysts, such as significant loss of cortical stroma with fibrosis formation and significantly lower follicular density [36][37][38]. These morphological alterations were never observed in samples from contralateral healthy ovaries.…”

Section: Reduced Ovarian Reserve In Patients Affected By Endometriosismentioning

confidence: 99%

The role of fertility preservation in patients with endometriosis

Carrillo

Seidman

Cittadini

et al. 2016

J Assist Reprod Genet

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Patients affected with severe endometriosis are at significant risk for ovarian tissue damage, which may lead to infertility, reduced response to ovarian stimulation, and occasionally, premature ovarian failure. The risk for a compromised ovarian reserve in young patients is especially high following repeated surgical intervention and in the presence of bilateral endometriomas. In many cases, enhanced loss of ovarian reserve may also result from the damaging effect of the pathologic process on follicle reservoir even without surgical interventions. Women diagnosed with severe endometriosis and those designated for extensive ovarian surgical intervention are frequently not planning to conceive. In light of recent advances in fertility preservation techniques (FPT), such as oocytes and ovarian tissue freezing, as well as their increasing success rates, we critically evaluate the options for FPT in patients suffering from endometriosis. Personalized counseling should be offered to all patients with endometriosis taking into account age, extent of ovarian involvement, current ovarian reserve, previous and impending surgeries for endometriosis, along with current success rates and possible risks associated with FPT.

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Section: Reduced Ovarian Reserve In Patients Affected By Endometriosismentioning

confidence: 99%

The role of fertility preservation in patients with endometriosis

Carrillo

Seidman

Cittadini

et al. 2016

J Assist Reprod Genet

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“…There is obviously an absence of a clear plane of cleavage close to the ovarian hilus. However, it has been published by the same group that the ovarian tissue adjacent to the endometrioma wall differs morphologically from normal ovarian tissue; it never shows the follicular pattern that is observed in normal ovaries (22). In experienced hands, laparoscopic stripping of endometriomas appears to be a technique that does not significantly damage the ovarian tissue.…”

Section: Total Cystectomymentioning

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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“…As for the mechanisms by which the affected gonads yield the lower number of oocytes than contra-lateral healthy gonads, several theories have been proposed. One is the reduction in ovarian volume by simultaneous removal of normal ovarian cortex at surgery [22,23]. Another is the reduction in vasculature due to hemostasis at surgery and/or inflammation induced by surgery [24,25].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic excision of ovarian endometrioma does not exert a qualitative effect on ovarian function: insights from in vitro fertilization and single embryo transfer cycles

Harada

Takahashi

Hirata

et al. 2015

J Assist Reprod Genet

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Purpose To evaluate whether laparoscopic excision of endometrioma exerts a qualitative effect on ovarian function. Methods A retrospective analysis of oocytes retrieved in 25 cycles of 21 patients undergoing IVF treatment with controlled ovarian stimulation. The number of oocytes recovered from ovaries with a history of excision of endometrioma (EOv) were compared to those from contra-lateral healthy ovaries (H-Ov) as for the analysis of a quantitative effect of surgery. As for the analysis of a qualitative effect, 55 oocytes from E-Ov were compared to 128 oocytes from H-Ov in terms of normal fertilization rate and the rate of top-quality embryos per normally fertilized eggs. Furthermore, 10 embryos derived from oocytes recovered from E-Ov were compared to 24 embryos derived from oocytes from H-Ov in terms of clinical and on-going pregnancy rates per embryos in 34 single embryo transfer cycles. Results Mean number of oocytes recovered from E-Ov was significantly smaller than that from H-Ov (2.2±2.0 vs. 5.1± 3.3, P=0.009). There was no difference between oocytes from E-Ov and H-Ov as for normal fertilization rate (63.6 % vs. 69.5 %, P=0.43) and the rate of top-quality embryos (40.0 % vs. 49.0 %, P=0.34). Clinical and on-going pregnancy rates per embryos were also similar in embryos derived from oocytes recovered from E-Ov and H-Ov (40.0 % vs. 25.0 %, P= 0.39 and 20.0 % vs. 20.8 %, P=0.96).Conclusions The quality of oocytes recovered from the ovary with a history of laparoscopic excision of endometrioma is not inferior to the quality of oocytes from contra-lateral healthy ovary.

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Laparoscopic excision of ovarian cysts: is the stripping technique a tissue-sparing procedure?

Cited by 246 publications

References 17 publications

The role of fertility preservation in patients with endometriosis

The role of fertility preservation in patients with endometriosis

Ovarian cystectomy in endometriomas: Combined approach

Laparoscopic excision of ovarian endometrioma does not exert a qualitative effect on ovarian function: insights from in vitro fertilization and single embryo transfer cycles

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