Effect of vasopressin injection technique in laparoscopic excision of bilateral ovarian endometriomas on ovarian reserve: prospective randomized study.
OBJECTIVE
To evaluate the effects of vasopressin injection technique in laparoscopic cystectomy on ovarian reserve in patients with bilateral endometriomas.


METHODS
Randomized prospective study (Canadian Task Force classification I).


METHODS
University hospital.


METHODS
Eighty-six women with bilateral endometriomas.


METHODS
Laparoscopic cystectomy of bilateral endometriomas was performed using different techniques including laparoscopic cystectomy by stripping without injection (control group), laparoscopic cystectomy by stripping with injection of saline solution (saline group), and laparoscopic cystectomy by stripping with vasopressin injection technique (VIT group).


RESULTS
The number of coagulation events on the ovarian cortex for hemostasis was counted in different groups, and the thickness of ovarian tissues removed was measured. The basal follicle-stimulating hormone (FSH) level was determined before surgery and at 3-, 6-, and 12-month follow-up after laparoscopic cystectomy in the different groups. In the saline group, fewer coagulation events were required to achieve hemostasis, less ovarian tissues were removed, and lower preoperative FSH levels were detected than in the control group (p < .01). In the VIT group, even fewer coagulation events (p < .01) and lower preoperative FSH levels (p < .01) were detected than in the saline group. There was no significant difference in the thickness of ovarian tissues removed in the 2 groups (p > .05). Basal FSH levels were significantly different before and after surgery in the control and saline groups (p < .01) but not in the VIT group (p > .05).


CONCLUSIONS
Vasopressin injection is an ideal procedure to reduce damage from usual laparoscopic cystectomy of bilateral ovarian endometriomas to protect ovarian reserve.
Department of Obstetrics and Gynecology, Second Affiliated Hospital of Soochow University. Electronic address: renqiongzhen@163.com.
Ren
R
Qiong-Zhen
Department of Immunology, Soochow University, the 100th Clinical of PLA OIAN.
Yan
Y
Ge
Department of Obstetrics and Gynecology, the 100th Hospital of the Chinese People's Liberation Army.
Yun
Y
Deng
Department of Obstetrics and Gynecology, Second Affiliated Hospital of Soochow University.
Zhi-Hong
ZH
Qian
Department of Obstetrics and Gynecology, Second Affiliated Hospital of Soochow University.
Wei-Pei
WP
Zhu
D000328:Adult; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery*; D065851:Ovarian Reserve; D011446:Prospective Studies; D016896:Treatment Outcome; D014667:Vasopressins / Q000008:administration & dosage*
D006490:Hemostatics; D014667:Vasopressins
Bilateral endometriomas; Follicle-stimulating hormone; Laparoscopic cystectomy; Ovarian reserve; Vasopressin