Effect of different hemostasis methods on the ovarian reserve functions in the cystectomy for ovarian endometriomas of nonparous women

Objective:To discuss the effect of different hemostasis methods on the ovarian reserve functions in the cystectomy for ovarian endometriomas of nonparous women.Methods:80 cases of nonparous women admitted into the hospital for the first time from October of 2009 to June of 2011 due to unilateral ovarian cysts were selected to perform cystectomy for ovarian endometriomas,of which,41 cases were performed laparoscopic surgery,39 laparotomy.Patients were divided into 2 groups,the simple suture hemostasis method group and the electrocoagulation hemostasis group due to the different hemostasis methods used in the intraoperative ovarian stripping wounds.In the laparoscopic surgery group,21 cases adopted laparoscopic electrocoagulation hemostasis method and 20 cases used simple suture hemostasis method;while in the laparotomy group,19 cases adopted electrocoagulation hemostasis method and 20 cases applied simple suture hemostasis method.In the 6th menstruation pre and postoperations,and 2nd and the 3rd day of the first menstruation 12 months after operations,the follicular stimulating hormone(FSH),luteinizing hormone(LH),estradiol level,sinus-shape follicle(Fo) number detected by vinginal ultrasound,peak systolic velocity(PSV) of the ovarian stroma artery blood flow and the ovarian volume(V) of the patients were detected respectively to determine the ovarian reserve functions.The results of comparing the preoperative general situation and the ovarian reserve functions of the patients in the 2 groups indicated that there was no statistical difference(P0.05).Results:There were statistical difference of all the indications in both groups except LH level 6 months and 12 months after surgeries compared with the indications before surgeries(P0.05).The indications of SH went up while E2,Fo number,PSV,V decresed in both groups 6 months and 12 months after operation compared with those before operation.Compared the LH level of both groups,there was no statistical difference(P0.05).Compared the electrocoagulation hemostasis group with the simple suture hemostasis group,the above-mentioned changes after six months became more obvious,which was of significant difference(P0.05).There were no statistical difference comparing all the indications of FSH,LH,E2,Fo,PSV and V six months after the operations with those twelve months after the operations(P0.05).Conclusion:After the cystectomy for ovarian endometriomas,it may result in the decrese of the ovarian reserve functions of the patients,and the electrocoagulation hemostasis method applied to the wound bleeding has more obivious effect on the decrese of the ovarian reserve function than the the simple suture hemostasis method.So the simple suture hemostasis will be suggested to use to treat the residual ovaries.If the electrocoagulation hemostasis method is needed,the electrocoagulation time will be advised to be shortened.Only when the area of the fulgurized tissues are reduced,the electrocoagulation of the parts of the ovarian hilus,can patients gain the true sense of minimally invasive treatment.