Endoscopic teatment for the infertile women suffered from endomertiosis, pelvic adhesion and polycystic ovarian deseas.

Takao Fukaya, Tadashi Watanabe, Junichi Sugawara, Akira Yajima
In: THE JOURNAL OF JAPAN SOCIETY FOR LASER SURGERY AND MEDICINE · 1995 · vol. 16(Supplement) , pp. 67–71 · doi:10.2530/jslsm1980.16.supplement_67 · W2326578872
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Endoscopic treatment of endometriosis, pelvic adhesions, and polycystic ovarian disease in infertile women improved pregnancy rates and reduced disease recurrence and ovarian hyperstimulation.

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The study evaluated, in infertile women with endometriosis, pelvic adhesions, and polycystic ovarian disease, the effectiveness of endoscopic laser treatment and the resulting pregnancy rates. Using a KTP/YAG laser system, investigators vaporized endometriotic implants and removed chocolate cysts; for pelvic adhesions they performed adhesiolysis, while polycystic disease patients were treated endoscopically, including those at risk of ovarian hyperstimulation syndrome, with outcomes reported as pregnancy rates and recurrence rates. The recurrence rate of chocolate cysts was 23.6% (and was reported as significantly lower than without surgical treatment), and pregnancy rates were higher after endoscopic treatment than with comparison approaches such as inspection only or danazol/Gn-Rh analogs. The paper does not describe details of study design, randomization, or specific methods for selecting comparators as limitations. This paper is centrally about endometriosis—endoscopic KTP/YAG laser vaporization of endometriotic implants and removal of chocolate cysts to improve fertility outcomes.

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Abstract

Among the women who suffered from endomertiosis, pelvic adhesion and polycystic ovarian deseas were treated by endosopic approach to evaluate the effectiveness and consequent pregnancy rate after endoscopic treatment. For endoscopic incision, coagulation and vaporization, KTP/YAG laser system was used. In the women with endometriosis, all endometriotic implants were vaporized and chocholate cysts were removed. The reccurrence rate in patients with chocholate cyst was 23.6%which was significantly lower than that in patient without surgical treatment, and moreover, the duration of deseas free period was longer than that in patient treated with danazol or Gn-Rh analoug. In cnsequence of these result, the pregnancy rate was relatively higher in the patients with endoscopic treatment. In the women with pelvic adhesion, the pregnancy rate was 47.5%in patients with adheiolysis which was significantly higher than in patient with inspection only (20.6%). In patients with polycystic desease who suffered from ovarian hyperstimulation syndrome, the pregnancy rate was 73.1%and the incidence rate of ovarian hyper stimulation was significantly reduced. These results indicated the effectiveness of endoscopic treatment for the infertle women with pelvic deseases.
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産婦人科骨盤内病変に対するレーザー治療 1995 年 16 巻 Supplement 号 p. 67-71 詳細 抄録 Among the women who suffered from endomertiosis, pelvic adhesion and polycystic ovarian deseas were treated by endosopic approach to evaluate the effectiveness and consequent pregnancy rate after endoscopic treatment. For endoscopic incision, coagulation and vaporization, KTP/YAG laser system was used. In the women with endometriosis, all endometriotic implants were vaporized and chocholate cysts were removed. The reccurrence rate in patients with chocholate cyst was 23.6%which was significantly lower than that in patient without surgical treatment, and moreover, the duration of deseas free period was longer than that in patient treated with danazol or Gn-Rh analoug. In cnsequence of these result, the pregnancy rate was relatively higher in the patients with endoscopic treatment. In the women with pelvic adhesion, the pregnancy rate was 47.5%in patients with adheiolysis which was significantly higher than in patient with inspection only (20.6%). In patients with polycystic desease who suffered from ovarian hyperstimulation syndrome, the pregnancy rate was 73.1%and the incidence rate of ovarian hyper stimulation was significantly reduced. These results indicated the effectiveness of endoscopic treatment for the infertle women with pelvic deseases. © 特定非営利活動法人 日本レーザー医学会

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