Electrocoagulation versus suture after laparoscopic stripping of ovarian endometriomas assessed by antral follicle count: preliminary results of randomized clinical trial.
OBJECTIVE
The assessment of ovarian reserve by antral follicle count (AFC) following electrocoagulation versus suture after laparoscopic stripping of ovarian endometriomas.


METHODS
Forty-five patients between 18 and 35 years, with unilateral endometriomas were randomly analyzed. Laparoscopic cystectomy was performed by the stripping method. Ovarian hemostasis was obtained either by suturing (group A, n = 23) or by bipolar electrocoagulation (group B, n = 22). AFC was performed by ultrasound on the third day of the three postoperative menstrual cycles. The sum of AFC was compared between sutured (A1) and electrocoagulated (B1) ovaries, as well as between intact ovaries of both groups (A0: intact ovaries in sutured group, B0: intact ovaries in electrocoagulated group).


RESULTS
The median of AFC was significantly lower in operated ovaries than in intact ovaries in both groups of patients, regardless of suturing [A1 median: 12 (range 9-19) vs. A0 median: 21.0 (range 15-27), p < 0.05] or electrocoagulation [B1: 5.0 (2-10) vs. B0: 18.5 (8-29), p < 0.05]. The median AFC was significantly higher in sutured ovaries than in electrocoagulated ovaries [A1: 12 (9-19) vs. B1: 5.0 (2-10), p < 0.05].


CONCLUSIONS
Our preliminary data show that operation on ovarian endometriomas could reduce ovarian reserve. The AFC value suggests that the ovarian reserve was less reduced in sutured ovaries than in those electrocoagulated. Suturing as a method of hemostasis could be a better choice after stripping ovarian endometriomas.
Coric
Mario
M
Department of Gynecological Surgery, Zagreb University Hospital Center, Zagreb, Croatia. mario.coric@zg.t-com.hr
Barisic
Dubravko
D
Pavicic
Dinka
D
Karadza
Magdalena
M
Banovic
Maja
M
D000293:Adolescent; D000328:Adult; D004564:Electrocoagulation / Q000009:adverse effects; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000601:surgery*; D006080:Ovarian Follicle / Q000473:pathology*; D010053:Ovary / Q000601:surgery; D013537:Sutures / Q000009:adverse effects; D055815:Young Adult