Ovarian endometrioma ablation using plasma energy versus cystectomy: a step toward better preservation of the ovarian parenchyma in women wishing to conceive.
OBJECTIVE
To use postoperative examination by three-dimensional (3D) ultrasound to compare loss of ovarian parenchyma after ovarian endometrioma ablation with the use of plasma energy versus cystectomy.


METHODS
Retrospective "before and after" comparative study.


METHODS
University tertiary referral center.


METHODS
Thirty women with no previous history of ovarian surgery managed for unilateral ovarian endometrioma >30 mm in diameter.


METHODS
Endometrioma ablation using plasma energy and ovarian tissue-sparing cystectomy.


METHODS
3D ultrasound assessment of postoperative reduction in ovarian volume and antral follicle count (AFC).


RESULTS
Fifteen women with comparable baseline characteristics were managed by each technique. Those who underwent cystectomy showed a statistically significant reduction in ovarian volume and AFC when compared with women who underwent ablation using plasma energy. Multivariate analysis showed that the relationship between the decrease in ovarian volume and AFC and the use of cystectomy remained statistically significant after adjustment for age, previous pregnancy, and cyst diameter.


CONCLUSIONS
When compared with plasma energy ablation, cystectomy is responsible for a statistically significant decrease in ovarian volume and a statistically significant reduction in AFC. This data should be taken into account in therapeutic decision-making concerning women attempting pregnancy, especially where there are other risk factors for postoperative ovarian failure.
Department of Gynecology and Obstetrics, Rouen University Hospital-Charles Nicolle, Rouen, France. horace.roman@gmail.com
Horace
H
Roman
Mathieu
M
Auber
Cécile
C
Mokdad
Cécile
C
Martin
Alain
A
Diguet
Loïc
L
Marpeau
Nicolas
N
Bourdel
D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D005306:Fertilization / Q000502:physiology; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D059351:Organ Sparing Treatments / Q000379:methods*; D010048:Ovarian Cysts / Q000150:complications / Q000601:surgery; D010049:Ovarian Diseases / Q000150:complications / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods; D010053:Ovary / Q000473:pathology / Q000601:surgery / Q000648:ultrastructure; D058626:Plasma Gases / Q000627:therapeutic use; D011247:Pregnancy; D012189:Retrospective Studies
D058626:Plasma Gases