Follicle loss after laparoscopic treatment of ovarian endometriotic cysts

Shi J, Jinghua Shi, Leng J, Jinhua Leng, Cui Q, Quancai Cui, Jinghe Lang, Lang J
International Journal of Gynecology & Obstetrics · 2011 · vol. 115(3) , pp. 277–281 · doi:10.1016/j.ijgo.2011.07.026 · PMID:21963194 · W2043069684
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Laparoscopic endometrioma cystectomy led to follicle loss, which was associated with cyst type, disease duration, and pain severity, while unilateral surgery effectively relieved pain without significantly altering FSH.

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Abstract

OBJECTIVE: To evaluate follicle loss and its associated factors during laparoscopic cystectomy for ovarian endometrioma. METHOD: Between October 2008 and December 2009, 140 patients with ovarian cysts undergoing laparoscopic cystectomy at Peking Union Medical Hospital were enrolled: 74 had ovarian endometrioma with no preoperative hormonal therapy (group A), 40 had ovarian endometrioma pretreated with GnRHa (group B), and 26 had non-endometriotic cysts (group C). Pre-, peri- , and postoperative clinical data were collected, and cyst specimens were evaluated histologically. RESULTS: The number of capsules showing follicles and the mean number of follicles per capsule were lower in group C than in group A or B (P<0.05). Fewer type IIC than type IIB endometriomas showed follicles (P<0.05). The number of follicles per cyst was related negatively to disease duration but positively to pain severity. Women in group A with unilateral endometrioma had a lower mean dysmenorrhea score after the surgery (P<0.05), but no change in basal follicle-stimulating hormone (FSH). CONCLUSION: The type of cyst, disease duration, and severity of dysmenorrhea were associated with ovarian follicle loss during laparoscopic excision of endometrioma. Laparoscopic unilateral cystectomy for endometrioma was effective in relieving pain but had little effect on serum FSH, which might reflect the remaining ovarian reserve.

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Condition tags

dysmenorrheaendometriosisendometrioma

MeSH descriptors

Endometriosis Laparoscopy Ovarian Cysts Ovarian Follicle Adolescent Adult China Dysmenorrhea Dysmenorrhea Endometriosis Female Follicle Stimulating Hormone Follicle Stimulating Hormone Follow-Up Studies Goserelin Goserelin Humans Laparoscopy Laparoscopy Middle Aged

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