Bipolar Electrocoagulation versus Suture of Solitary Ovary after Laparoscopic Excision of Ovarian Endometriomas

Luigi Fedele, Stefano Bianchi, Zanconato G, Giovanni Zanconato, Bergamini V, Valentino Bergamini, Nicola Berlanda
The Journal of the American Association of Gynecologic Laparoscopists · 2004 · vol. 11(3) , pp. 344–347 · doi:10.1016/s1074-3804(05)60048-5 · PMID:15559346 · W1969522272
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This study compared bipolar electrocoagulation and suture methods for closing solitary ovarian defects after laparoscopic endometrioma excision in women.

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Abstract

Study objectiveTo compare the functional ovarian damage associated with the use of bipolar coagulation versus ovarian suture after laparoscopic excision of ovarian endometriomas in patients with a solitary ovary.DesignRetrospective study (Canadian Task Force classification II-3).SettingTertiary care center.PatientsForty-seven consecutive women with a single ovary and regular menses who underwent laparoscopic stripping of one or more ovarian endometriomas between June 1996 and June 2001. Intervention. Twenty-one patients had bipolar electrocoagulation (group A), while 26 had suturing of the ovary (group B). Plasma follicle-stimulating hormone (FSH) and estradiol levels were determined before surgery and re-evaluated at 3-, 6-, and 12-month follow-up.Measurements and main resultsAt 12-month follow-up, six patients (29%) in group A had oligo-amenorrhea versus three patients (12%) in group B (p = .14). Follicle-stimulating hormone levels between 10 and 20 mlU/mL were found in five patients (24%) in group A and in three patients (12%) in group B, whereas FSH levels above 20 mlU/mL were found in three patients (14%) in group A and in no patient in group B. Eight patients (38%) in group A had FSH levels greater than 10 mlU/mL versus three patients (12%) in group B (p = .042). Overall, repeated analysis of variance showed a marginally significant difference (p = .06) in FSH values between the two groups.ConclusionOur results suggest that bipolar electrocoagulation of the ovarian parenchyma after laparoscopic stripping of an endometriotic ovarian cyst adversely affects ovarian function.

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Condition tags

endometriosis

MeSH descriptors

Electrocoagulation Endometriosis Ovarian Cysts Ovarian Diseases Ovary Suture Techniques Adult Endometriosis Estradiol Estradiol Female Follicle Stimulating Hormone Follicle Stimulating Hormone Humans Ovarian Cysts Ovarian Diseases Ovary Ovary Retrospective Studies

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