Anti-Mullerian hormone trend evaluation after laparoscopic surgery of monolateral endometrioma using a new dual wavelengths laser system (DWLS) for hemostasis

Abstract

Operative laparoscopy is the gold standard in the treatment of endometriotic ovarian cysts. Excisional surgery is the best technique to prevent recurrences and improve symptoms but it may result in ovarian reserve damage due to the removal of healthy ovarian cortex. The aim of this study was to assess the impact on ovarian reserve of the use of dual wavelengths laser system (DWLS) hemostasis after stripping technique of monolateral endometrioma, by dosing the anti-Mullerian hormone (AMH). This prospective study was conducted at the Institute of Obstetrics and Gynecology, University of Foggia, from December 2013 to January 2015. Forty-five women underwent excision of monolateral endometriotic ovarian cyst by stripping without using a bipolar coagulation and performing hemostasis with a DWLS. The AMH serum levels were estimated before the surgery (T0), 4–6 weeks (T1) and 6–9 months (T2) after surgery. Our results suggest that an appropriate surgical technique with the use of laser hemostasis does not determine a significant reduction of ovarian reserve. Laser hemostasis could prevent follicular reserve loss after ovarian endometrioma surgery.

Chinese abstract

腹腔镜手术是治疗卵巢子宫内膜异位囊肿的金标准。外科手术切除是预防复发和改善症状的最佳方法。但是切除了正常的卵巢皮质可能会引起卵巢储备功能受损。本研究的目标是通过定量测定抗苗勒氏管激素（AMH）评估单侧卵巢子宫内膜异位囊肿剥除术后用双波长激光系统（DWLS）止血对卵巢储备功能的影响。这项前瞻性研究是由Foggia大学妇产科学院从2013年12月到2015年1月进行的。45名女性进行了单侧卵巢子宫内膜异位囊肿剥除术，术中未使用双极电凝，而是使用了双波长激光系统止血。在术前（T0）、术后4～6周（T1）和术后6～9个月（T2）检测血清AMH水平。我们的结果表明合适的手术联合使用激光止血没有明显减少卵巢储备功能。激光止血可以预防卵巢子宫腺肌症术后储备的卵泡丢失。

• AMH
• endometriosis
• laser hemostasis
• ovarian reserve

Declaration of interest

The authors have no conflicts of interest to declare.

Supplementary material available online Supplementary Table S1