title: Compared with cystectomy, is ovarian vaporization of endometriotic cysts truly more effective in maintaining ovarian reserve?
abstract: OBJECTIVE
  To evaluate how endometriotic cystectomy and vaporization affect ovarian reserve after conservative surgery.
  
  
  METHODS
  Prospective study (Canadian Task Force classification II-1).
  
  
  METHODS
  Hokusetsu General Hospital.
  
  
  METHODS
  Ninety-nine women who underwent conservative surgery to treat endometriotic cysts from June 2011 to July 2013.
  
  
  METHODS
  Vaporization with bipolar current was performed in nulligravid women, and cystectomy in those who had a child. In women with endometriotic cysts, bilateral cystectomy was performed in 28, bilateral vaporization in 15, unilateral cystectomy in 40, and unilateral vaporization in 16. In all patients, preoperative and postoperative serum anti-müllerian hormone (AMH) and follicle-stimulating hormone (FSH) concentrations at the early proliferative phase were assayed, and the change in concentrations was evaluated for each operation.
  
  
  RESULTS
  In the bilateral cystectomy group, the mean (SD) postoperative FSH concentration (19.3 [21.8] IU/mL) was statistically higher than the preoperative concentration (9.0 [6.2] IU/mL) (p < .01). AMH significantly declined after all operations to treat endometriotic cysts, and the rate of decline in the AMH concentration was >50% compared with preoperative concentrations.
  
  
  CONCLUSIONS
  Whether endometriotic cysts are unilateral or bilateral, both cystectomy and vaporization using bipolar current can lower ovarian reserve. Therefore, it is necessary to develop more effective surgical procedures to prevent ovarian damage.
authors.affiliation: Department Obstetrics and Gynecology, Hokusetsu General Hospital, Osaka, Japan.
authors.forename: Natsuho
authors.initials: N
authors.lastname: Saito
authors.affiliation: Department Obstetrics and Gynecology, Hokusetsu General Hospital, Osaka, Japan.
authors.forename: Kiyoji
authors.initials: K
authors.lastname: Okuda
authors.affiliation: Department Obstetrics and Gynecology, Hokusetsu General Hospital, Osaka, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Yuguchi
authors.affiliation: Department Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan. Electronic address: gyn028@poh.osaka-med.ac.jp.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Terai
authors.affiliation: Department Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Ohmichi
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015653:Cystectomy; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D053685:Laser Therapy; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D010048:Ovarian Cysts / Q000601:surgery*; D065851:Ovarian Reserve; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone
keywords: AMH; Endometriotic cyst; FSH; Laparoscopic surgery; Ovarian reserve