Laparoscopic cystectomy of endometrioma

Good surgical technique does not adversely affect ovarian reserve

Rajeshwari G. Bhat, Sushma Dhulked, Amar Ramachandran, Rajesh Bhaktha, Akhila Vasudeva, Pratap Kumar, Anuradha C.K. Rao

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The damage to ovarian reserve inflicted by surgery for endometriosis represents a major concern in the balance between reproductive benefits and risks. Aim: To evaluate the ovarian reserve in sub fertile women after laparoscopic endometriotic cystectomy. Settings and Design: Prospective study, done in Department of Obstetrics and Gynecology, tertiary care hospital between August 2010-2012. Materials and Method: Laparoscopic cystectomy performed by stripping technique for endometriotic cysts. Endometriosis was staged according to revised American Society of Reproductive Medicine classification (rASRM). Ovarian reserve assessed by comparing FSH and LH levels, measurement of residual ovarian volume, antral follicle counts and stromal blood flow on second day of menses pre and postoperatively. Cyst wall was evaluated histologically to note the presence of normal ovarian tissue in resected tissue. Statistical Analysis: SPSS for Windows version 16.0 (SPSS Inc., Chicago, IL) was used for statistical calculations. Wilcoxon signed test and Pearson Chi - Square test were applied. Significance level was P < 0.05. Results: Incidence of minimal, mild, moderate, and severe endometriosis was 4.1%, 21.9%, 28.7%, 45.3% respectively. Ovarian reserve was assessed both by ultrasound and biochemical parameters on day 2 of menses; pre and post-operatively. Preoperative and post-operative values; FSH (7.24 ± 1.21, 7.23 ± 1.51 m IU/ml), LH levels (6.37 ± 1.8, 6.6 ± 2.3 m IU/ml), residual ovarian volume (8.5 cm3± 5.3, 7.4 cm3± 5.8), antral follicle count(3.3 ± 1.9, 4.1 ± 1.5) and stromal blood flow (6.8 cm/sec ± 4.57, 7.1 cm/sec ± 3.55) were statistically not significant. Loss of follicle was seen in 27.2% cyst walls on histopathological examination while 72.73% had no loss. Conclusion: Laparoscopic cystectomy when performed for endometriotic cysts with accurate surgical technique leads to no significant ovarian tissue removal.

Original languageEnglish
Pages (from-to)125-129
Number of pages5
JournalJournal of Human Reproductive Sciences
Volume7
Issue number2
DOIs
Publication statusPublished - 01-01-2014

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Cystectomy
Endometriosis
Cysts
Residual Volume
Menstruation
Reproductive Medicine
Hospital Obstetrics and Gynecology Department
Tertiary Healthcare
Chi-Square Distribution
Gynecology
Tertiary Care Centers
Prospective Studies
Ovarian Reserve
Incidence
Antral

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine

Cite this

Bhat, Rajeshwari G. ; Dhulked, Sushma ; Ramachandran, Amar ; Bhaktha, Rajesh ; Vasudeva, Akhila ; Kumar, Pratap ; Rao, Anuradha C.K. / Laparoscopic cystectomy of endometrioma : Good surgical technique does not adversely affect ovarian reserve. In: Journal of Human Reproductive Sciences. 2014 ; Vol. 7, No. 2. pp. 125-129.
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abstract = "Background: The damage to ovarian reserve inflicted by surgery for endometriosis represents a major concern in the balance between reproductive benefits and risks. Aim: To evaluate the ovarian reserve in sub fertile women after laparoscopic endometriotic cystectomy. Settings and Design: Prospective study, done in Department of Obstetrics and Gynecology, tertiary care hospital between August 2010-2012. Materials and Method: Laparoscopic cystectomy performed by stripping technique for endometriotic cysts. Endometriosis was staged according to revised American Society of Reproductive Medicine classification (rASRM). Ovarian reserve assessed by comparing FSH and LH levels, measurement of residual ovarian volume, antral follicle counts and stromal blood flow on second day of menses pre and postoperatively. Cyst wall was evaluated histologically to note the presence of normal ovarian tissue in resected tissue. Statistical Analysis: SPSS for Windows version 16.0 (SPSS Inc., Chicago, IL) was used for statistical calculations. Wilcoxon signed test and Pearson Chi - Square test were applied. Significance level was P < 0.05. Results: Incidence of minimal, mild, moderate, and severe endometriosis was 4.1{\%}, 21.9{\%}, 28.7{\%}, 45.3{\%} respectively. Ovarian reserve was assessed both by ultrasound and biochemical parameters on day 2 of menses; pre and post-operatively. Preoperative and post-operative values; FSH (7.24 ± 1.21, 7.23 ± 1.51 m IU/ml), LH levels (6.37 ± 1.8, 6.6 ± 2.3 m IU/ml), residual ovarian volume (8.5 cm3± 5.3, 7.4 cm3± 5.8), antral follicle count(3.3 ± 1.9, 4.1 ± 1.5) and stromal blood flow (6.8 cm/sec ± 4.57, 7.1 cm/sec ± 3.55) were statistically not significant. Loss of follicle was seen in 27.2{\%} cyst walls on histopathological examination while 72.73{\%} had no loss. Conclusion: Laparoscopic cystectomy when performed for endometriotic cysts with accurate surgical technique leads to no significant ovarian tissue removal.",
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Laparoscopic cystectomy of endometrioma : Good surgical technique does not adversely affect ovarian reserve. / Bhat, Rajeshwari G.; Dhulked, Sushma; Ramachandran, Amar; Bhaktha, Rajesh; Vasudeva, Akhila; Kumar, Pratap; Rao, Anuradha C.K.

In: Journal of Human Reproductive Sciences, Vol. 7, No. 2, 01.01.2014, p. 125-129.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Laparoscopic cystectomy of endometrioma

T2 - Good surgical technique does not adversely affect ovarian reserve

AU - Bhat, Rajeshwari G.

AU - Dhulked, Sushma

AU - Ramachandran, Amar

AU - Bhaktha, Rajesh

AU - Vasudeva, Akhila

AU - Kumar, Pratap

AU - Rao, Anuradha C.K.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: The damage to ovarian reserve inflicted by surgery for endometriosis represents a major concern in the balance between reproductive benefits and risks. Aim: To evaluate the ovarian reserve in sub fertile women after laparoscopic endometriotic cystectomy. Settings and Design: Prospective study, done in Department of Obstetrics and Gynecology, tertiary care hospital between August 2010-2012. Materials and Method: Laparoscopic cystectomy performed by stripping technique for endometriotic cysts. Endometriosis was staged according to revised American Society of Reproductive Medicine classification (rASRM). Ovarian reserve assessed by comparing FSH and LH levels, measurement of residual ovarian volume, antral follicle counts and stromal blood flow on second day of menses pre and postoperatively. Cyst wall was evaluated histologically to note the presence of normal ovarian tissue in resected tissue. Statistical Analysis: SPSS for Windows version 16.0 (SPSS Inc., Chicago, IL) was used for statistical calculations. Wilcoxon signed test and Pearson Chi - Square test were applied. Significance level was P < 0.05. Results: Incidence of minimal, mild, moderate, and severe endometriosis was 4.1%, 21.9%, 28.7%, 45.3% respectively. Ovarian reserve was assessed both by ultrasound and biochemical parameters on day 2 of menses; pre and post-operatively. Preoperative and post-operative values; FSH (7.24 ± 1.21, 7.23 ± 1.51 m IU/ml), LH levels (6.37 ± 1.8, 6.6 ± 2.3 m IU/ml), residual ovarian volume (8.5 cm3± 5.3, 7.4 cm3± 5.8), antral follicle count(3.3 ± 1.9, 4.1 ± 1.5) and stromal blood flow (6.8 cm/sec ± 4.57, 7.1 cm/sec ± 3.55) were statistically not significant. Loss of follicle was seen in 27.2% cyst walls on histopathological examination while 72.73% had no loss. Conclusion: Laparoscopic cystectomy when performed for endometriotic cysts with accurate surgical technique leads to no significant ovarian tissue removal.

AB - Background: The damage to ovarian reserve inflicted by surgery for endometriosis represents a major concern in the balance between reproductive benefits and risks. Aim: To evaluate the ovarian reserve in sub fertile women after laparoscopic endometriotic cystectomy. Settings and Design: Prospective study, done in Department of Obstetrics and Gynecology, tertiary care hospital between August 2010-2012. Materials and Method: Laparoscopic cystectomy performed by stripping technique for endometriotic cysts. Endometriosis was staged according to revised American Society of Reproductive Medicine classification (rASRM). Ovarian reserve assessed by comparing FSH and LH levels, measurement of residual ovarian volume, antral follicle counts and stromal blood flow on second day of menses pre and postoperatively. Cyst wall was evaluated histologically to note the presence of normal ovarian tissue in resected tissue. Statistical Analysis: SPSS for Windows version 16.0 (SPSS Inc., Chicago, IL) was used for statistical calculations. Wilcoxon signed test and Pearson Chi - Square test were applied. Significance level was P < 0.05. Results: Incidence of minimal, mild, moderate, and severe endometriosis was 4.1%, 21.9%, 28.7%, 45.3% respectively. Ovarian reserve was assessed both by ultrasound and biochemical parameters on day 2 of menses; pre and post-operatively. Preoperative and post-operative values; FSH (7.24 ± 1.21, 7.23 ± 1.51 m IU/ml), LH levels (6.37 ± 1.8, 6.6 ± 2.3 m IU/ml), residual ovarian volume (8.5 cm3± 5.3, 7.4 cm3± 5.8), antral follicle count(3.3 ± 1.9, 4.1 ± 1.5) and stromal blood flow (6.8 cm/sec ± 4.57, 7.1 cm/sec ± 3.55) were statistically not significant. Loss of follicle was seen in 27.2% cyst walls on histopathological examination while 72.73% had no loss. Conclusion: Laparoscopic cystectomy when performed for endometriotic cysts with accurate surgical technique leads to no significant ovarian tissue removal.

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