Effect on ovarian reserve of laparoscopic bipolar electrocoagulation versus laparotomic hemostatic sutures during unilateral ovarian cystectomy

• Published in: International journal of gynecology and obstetrics Vol. 114; no. 1; pp. 69 - 72
• Main Authors: Mohamed, Mohamed L, Nouh, Amal A, El-Behery, Manal M, Mansour, Shymaa A.E.-A
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01-07-2011; Elsevier
• Subjects: Adolescent; Adult; Anti-Mullerian Hormone - blood; Biological and medical sciences; Digestive system. Abdomen; Electrocoagulation - adverse effects; Electrocoagulation - methods; Endoscopy; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Hemostasis, Surgical - adverse effects; Hemostasis, Surgical - methods; Humans; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy - adverse effects; Laparoscopy - methods; Laparotomy - adverse effects; Laparotomy - methods; Medical sciences; Obstetrics and Gynecology; Ovarian cystectomy; Ovarian cysts; Ovarian Cysts - pathology; Ovarian Cysts - surgery; Ovarian Follicle - pathology; Ovarian reserve; Ovary - pathology; Ovary - surgery; Prospective Studies; Suture Techniques; Tumors; Young Adult; Ovarian cystectomy; Ovarian reserve; Ovarian cysts; Reserve; Hemostatic; Gynecology; Bipolar electrocoagulation; Laparoscopy; Obstetrics; Female genital diseases; Ovarian cyst; Ovary; Ovarian diseases; Cystectomy; Treatment; Surgery; Unilateral; Endoscopy; Comparative study; Suture
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2011.01.010

Abstract Objective To compare the effects of laparoscopic bipolar electrocoagulation with laparotomic hemostatic suturing during unilateral ovarian cystectomy on the ovarian reserve. Methods A prospective randomized trial was conducted on 59 women with unilateral benign ovarian cysts who underwent laparoscopic ovarian cystectomy by a stripping technique (n = 30) or open laparotomy with hemostatic suturing (n = 29). Serum anti-Müllerian hormone (AMH), antral follicle count (AFC), and ovarian stromal peak systolic velocity (PSV) at the 1st, 3rd, and 6th postoperative cycle were used to assess the ovarian reserve. Results Preoperative AMH levels did not differ significantly ( P = 0.18) between the laparoscopy and laparotomy groups. In the laparoscopy group, there was a significant decrease in AMH levels, AFC, and PSV at the 3rd and 6th postoperative cycles compared with the 1st postoperative cycle, with an insignificant decrease between the 3rd and 6th cycles. In the laparotomy group, nonsignificant decreases in AMH levels, AFC, and PSV were detected at the 1st, 3rd, and 6th postoperative cycle and between the 3rd and 6th cycles. Conclusion Laparoscopic ovarian cystectomy is associated with a significant reduction in ovarian reserve. This is a consequence of damage to the ovarian vascularity and the removal of an increased amount of ovarian tissue.