Impact of hemostatic methods on ovarian reserve and fertility in laparoscopic ovarian cystectomy
- Authors:
- Jie Xiao
- Jian Zhou
- Hui Liang
- Fumin Liu
- Chenchen Xu
- Li Liang
View Affiliations
Affiliations: Department of Gynecology, Xuzhou Maternity and Child Health Care Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221009, P.R. China, Cervical Disease Center, Xuzhou Maternity and Child Health Care Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221009, P.R. China, Department of Gynaecology and Obstetrics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221009, P.R. China, B Ultrasonic Room, Xuzhou Maternity and Child Health Care Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221009, P.R. China
- Published online on: February 12, 2019 https://doi.org/10.3892/etm.2019.7259
-
Pages:
2689-2693
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Copyright: © Xiao
et al. This is an open access article distributed under the
terms of Creative
Commons Attribution License.
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Abstract
Impact of hemostatic methods, electrocoagulation versus suture, on ovarian reserve and fertility in laparoscopic ovarian cystectomy was investigated. Eighty patients with bilateral ovarian cysts who underwent laparoscopic ovarian cystectomy were randomly divided into 2 groups based on the hemostatic methods: 40 in suture group and another 40 in electrocoagulation group. Blood samples were drawn from all patients at roughly three time points: Before the surgery, 1 month and 6 months after the surgery. Radioimmunoassay was performed to measure the serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and anti-Mullerian hormone (AMH). Moreover, the vaginal ultrasound examination was performed to obtain the ovarian size, peak systolic velocity (PSV) of ovarian stromal blood flow, and antral follicle count (AFC). In terms of postoperative ovarian reserve, the levels of E2 and AMH slightly decreased while the FSH level slightly increased in the suture group at both 1 and 6 months after surgery. In the electrocoagulation group, however, the levels of E2 and AMH decreased significantly while the FSH level increased significantly at 1 month after surgery. Six months after surgery, these levels all returned slightly showing some recovery of ovarian reserve. In comparison between the suture group and the electrocoagulation group, the differences in levels of E2, FSH and AMH were all statistically significant at both 1 and 6 months after surgery (P<0.05). Six months after surgery, the differences in AFC and PSV between the suture group and the electrocoagulation group were statistically significant (P<0.05). In laparoscopic ovarian cystectomy, hemostatic electrocoagulation had a more negative impact on ovarian reserve than hemostatic suture. The use of electrocoagulation for hemostasis should be minimized during the operation, and the suture method should be adopted for hemostasis and shaping of the ovarian wound.
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