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This study evaluated how paraportal versus peripheral localization of a unilateral endometriotic ovarian cyst (2–8 cm) affects ovarian reserve and the intensity of chronic pelvic pain in 100 patients with chronic pelvic pain associated with external genital endometriosis, using ultrasound and hormonal measures (antral follicle count, power Doppler vascularization and flow indices, AMH, and FSH) and the Biberoglu and Behrman scale for pain. Compared with 30 controls without ovarian cysts and with preserved reproductive function, patients with endometriotic ovarian cysts had a 22–50% decrease in ovarian reserve across AMH, FSH, antral follicles, and Doppler indices. The ovarian reserve was significantly more reduced and chronic pelvic pain more intense in the paraportal localization group than in the peripheral localization group, with laparoscopic findings confirming localization and capsular attachment firmness intraoperatively. This paper is centrally about endometriosis — it focuses on how localization of an endometriotic ovarian cyst relates to ovarian reserve and chronic pelvic pain intensity.
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Gynecology, Obstetrics and Perinatology - Gynecology, Obstetrics and Perinatology - 2019 volume 18 issue 2
Paraportal localisation of an endometriotic ovarian cyst and its influence on ovarian reserve and intensity of chronic pelvic pains
Authors / Institutions
Aleksandr S. Gasparov /
Mark F. Dorfman /
Ekaterina D. Dubinskaya /
A.G.Kosachenko /
Mekan R.Orazov /
Suren L. Vartanyan /
Sofia F. Dorfman /
The objective. To assess the influence of paraportal and peripheral localisation of an endometriotic ovarian cyst on ovarian reserve and the quality of life of patients.
Patients and methods. The study included 100 patients with monolateral endometriotic ovarian cysts with sizes from 2 to 8 cm and chronic pelvic pains associated with external genital endometriosis. Two groups were singled out: group 1 consisted of 30 patients with paraportal localisation of the cyst and chronic pelvic pain; group 2 – 70 patients with peripheral localisation of an endometriotic cyst and chronic pelvic pain. The control group comprised 30 patients with preserved reproductive function
without ovarian cysts. Ovarian reserve was assessed by ultrasound and hormonal examinations including antral follicle count, power Doppler imaging with vascularisation (VI) and flow indices (FI), anti-Mullerian (AMH) and follicle-stimulating hormone (FSH) testing. The intensity of chronic pelvic pains was assessed by the Biberoglu and Behrman scale. Laparoscopic surgery was performed, paraportal or peripheral localisation of the cyst and the firmness of capsular attachment were confirmed
intraoperatively.
Results. In patients with endometriotic cysts a decrease of ovarian reserve by 22–50% was found as compared with women from the control group: AMH – 36%, FSH – 37.4%, AF – 50%, VI – 43%, FI – 22.7%. Examination of ovarian reserve in patients with paraportal location of endometriomas found its significant decrease and a more marked intensity of chronic pelvic pains as compared with the results in case of peripheral localisation of a cyst.
Conclusion. Paraportal localisation of an endometriotic cyst conditions a more significant decrease of ovarian reserve as compared with its peripheral localisation. In paraportal localisation of an endometriotic cyst the quality of life decreases to a greater extent due to more intense chronic pelvic pain.
Key words: ovarian reserve, paraportal, peripheral localisation of endometriotic cyst, chronic pelvic pains, endometriotic ovarian cyst.
For citation: Gasparov A.S., Dorfman M.F., Dubinskaya E.D., Kosachenko A.Zh., Orazov M.R., Vartanyan S.L., Dorfman S.F. Paraportal localisation of an endometriotic ovarian cyst and its influence on ovarian reserve and intensity of chronic pelvic pains. Vopr. ginekol. akus. perinatol. (Gynecology,
Obstetrics and Perinatology). 2019; 18(2): 27–33. (In Russian).
DOI: 10.20953/1726-1678-2019-2-27-33
Patients and methods. The study included 100 patients with monolateral endometriotic ovarian cysts with sizes from 2 to 8 cm and chronic pelvic pains associated with external genital endometriosis. Two groups were singled out: group 1 consisted of 30 patients with paraportal localisation of the cyst and chronic pelvic pain; group 2 – 70 patients with peripheral localisation of an endometriotic cyst and chronic pelvic pain. The control group comprised 30 patients with preserved reproductive function
without ovarian cysts. Ovarian reserve was assessed by ultrasound and hormonal examinations including antral follicle count, power Doppler imaging with vascularisation (VI) and flow indices (FI), anti-Mullerian (AMH) and follicle-stimulating hormone (FSH) testing. The intensity of chronic pelvic pains was assessed by the Biberoglu and Behrman scale. Laparoscopic surgery was performed, paraportal or peripheral localisation of the cyst and the firmness of capsular attachment were confirmed
intraoperatively.
Results. In patients with endometriotic cysts a decrease of ovarian reserve by 22–50% was found as compared with women from the control group: AMH – 36%, FSH – 37.4%, AF – 50%, VI – 43%, FI – 22.7%. Examination of ovarian reserve in patients with paraportal location of endometriomas found its significant decrease and a more marked intensity of chronic pelvic pains as compared with the results in case of peripheral localisation of a cyst.
Conclusion. Paraportal localisation of an endometriotic cyst conditions a more significant decrease of ovarian reserve as compared with its peripheral localisation. In paraportal localisation of an endometriotic cyst the quality of life decreases to a greater extent due to more intense chronic pelvic pain.
Key words: ovarian reserve, paraportal, peripheral localisation of endometriotic cyst, chronic pelvic pains, endometriotic ovarian cyst.
For citation: Gasparov A.S., Dorfman M.F., Dubinskaya E.D., Kosachenko A.Zh., Orazov M.R., Vartanyan S.L., Dorfman S.F. Paraportal localisation of an endometriotic ovarian cyst and its influence on ovarian reserve and intensity of chronic pelvic pains. Vopr. ginekol. akus. perinatol. (Gynecology,
Obstetrics and Perinatology). 2019; 18(2): 27–33. (In Russian).
DOI: 10.20953/1726-1678-2019-2-27-33
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