Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst

karadağ, cihan; demircan, sinem; Turgut, Abdulkadir; Caliskan, Eray

doi:10.4274/tjod.galenos.2020.37605

Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst

Cihan KARADAĞ, (Okan Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Sinem DEMİRCAN KARADAĞ, (İstanbul Medeniyet Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Abdulkadir TURGUT, (İstanbul Medeniyet Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Eray ÇALIŞKAN (Okan Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Turkish Journal of Obstetrics and Gynecology

0 0

Yıl: 2020 Cilt: 17 Sayı: 1 Sayfa Aralığı: 15 - 20 Metin Dili: İngilizce DOI: 10.4274/tjod.galenos.2020.37605 İndeks Tarihi: 27-06-2021

Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst

Öz:

Objective: To compare the effects of laparoscopic cystectomy on ovarian reserve between women with endometrioma and dermoid cyst. Materials and Methods: Thirty-six patients were diagnosed as having endometrioma (group A) and 32 patients with dermoid cyst (group B) using ultrasonography. Preoperative anti-mullerian hormone (AMH) levels were measured and unilateral antral follicle counts (AFC) were calculated for the ovary side containing the cyst. Laparoscopic cystectomy was performed using the stripping technique for all participants. After 3 months, all participants were side containing the cyst. Laparoscopic cystectomy was performed using the stripping technique for all participants. After 3 months, all participants were Results: The mean serum preoperative AMH level and AFC level were significantly lower in group A than in group B (p=0.001, p=0.002), respectively. At 3 months after the surgery, serum AMH levels decreased significantly in group A from 2.04±0.68 to 1.47±0.55 (p=0.001), and from 2.60±0.57 to 2.17±0.56 in group B (p=0.001). In group A, unilateral (operated side) AFC levels decreased significantly from 4.05±1.24 to 2.16±0.94 (p=0.001), and in group B, it decreased significantly from 4.93±0.94 to 3.40±0.87 (p=0.001). The decrease in AMH levels was significantly higher in group A than in group B (p=0.033). The decrease in AFC levels was also significantly higher in group A than in group B (p=0.044).Conclusion: Laparoscopic stripping has destructive effects on serum AMH levels and the operated side AFC levels after surgery for patients with endometrioma and dermoid cysts, and laparoscopic excision of endometrioma has more destructive effects on ovarian reserve than dermoid cysts.

Anahtar Kelime:

Endometriomalı ve dermoid kistli hastalarda laparoskopik kistektominin ovaryan rezerv üstüne etkisi

Öz:

Amaç: Laparoskopik kistektominin ovaryan rezerv üzerine etkisini endometriomalı ve dermoid kistli hastalarda karıştırmaktır. Gereç ve Yöntemler: Ultrasonografik olarak preoperatif tanı konulmuş 36 endometriomalı (grup A) ve 32 dermoid kistli (grup B) hasta çalışmaya alındı. Preoperatif anti-mullerian hormon (AMH) ve kistin olduğu overdeki antral folikül sayıları (AFC) ölçüldü. Tüm hastalara laparoskopik kistektomi stripping tekniği uygulanarak yapıldı. Ameliyattan 3 ay sonra tüm hastaların AMH ve AFC ölçümleri siklusun 3. ve 6. günleri arası tekrar yapıldı. Bulgular: Preoperatif serum AMH seviyeleri ve opere olan taraftaki AFC değerleri grup A’da grup B’de göre anlamlı derecede düşük saptandı [(p=0,001),(p=0,002)], sırasıyla. Ameliyattan 3 ay sonra serum AMH seviyesi grup A’da 2,04±0,68’den 1,47±0,55’e (p=0,001), grup B’de 2,60±0,57’den 2,17±0,56’ya (p=0,001) düştü. AFC seviyesi grup A’da ameliyattan 3 ay sonra 4,05±1,24’ten 2,16±0,94’e, grup B’de 4,93±0,94’den 3,40±0,87’ye (p=0,001) düşmüştür. AMH seviyesindeki düşüş grup A’da grup B’ye göre anlamlı derecede daha fazla olarak görüldü (p=0,033). AFC değerindeki düşüş grup A’da grup B’ye göre anlamlı oranda daha fazla idi (p=0,044).Sonuç: Laparoskopik stripping tekniği hem endometriomalı hem de dermoid kistli hastalarda serum AMH ve opere olan taraftaki AFC seviyeleri üstünde yıkıcı etkilere sahiptir. Endometriomaların laparoskopik olarak çıkartılması ovaryan rezerv üzerine dermoid kistlere göre daha yıkıcı etkilere sahiptir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Gelbaya TA, Nardo LG. Evidence-based management of endometrioma. Reproductive Biomedicine Online 2011;23:15-24.
2. Kim MJ, Kim NY, Lee DY, Yoon BK, Choi D. Clinical characteristics of ovarian teratoma: age-focused retrospective analysis of 580 cases. Am J Obstet Gynecol 2011;205:e1-e4.
3. Chapron C, Fauconnier A, Goffinet F, Breart G, Dubuisson J. Laparoscopic surgery is not inherently dangerous for patients presenting with benign gynaecologic pathology. Results of a metaanalysis. Human Reproduction 2002;17:1334-42.
4. Medeiros LR, Rosa DD, Bozzetti MC, Fachel JM, Furness S, Garry R, et al. Laparoscopy versus laparotomy for benign ovarian tumour. Cochrane Database of Systematic Reviews 2009.
5. Hart RJ, Hickey M, Maouris P, Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database of Syst Rev 2008.
6. Maheshwari A, Fowler P, Bhattacharya S. Assessment of ovarian reserve—should we perform tests of ovarian reserve routinely? Human Reproduction 2006;21:2729-35.
7. La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, et al. Anti-mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update 2009;16:113-30.
8. Muzii L, Di Tucci C, Di Feliciantonio M, Marchetti C, Perniola G, Panici PB. The effect of surgery for endometrioma on ovarian reserve evaluated by antral follicle count: a systematic review and meta-analysis. Hum Reprod 2014;29:2190-8.
9. Shah DK, Mejia RB, Lebovic DI. Effect of surgery for endometrioma on ovarian function. J Minim Invasive Gynecol 2014;21:203-9.
10. Somigliana E, Berlanda N, Benaglia L, Viganò P, Vercellini P, Fedele L. Surgical excision of endometriomas and ovarian reserve: a systematic review on serum antimüllerian hormone level modifications. Fertil Steril 2012;98:1531-8.
11. Goodman LR, Goldberg JM, Flyckt RL, Gupta M, Harwalker J, Falcone T. Effect of surgery on ovarian reserve in women with endometriomas, endometriosis and controls. Am J Obstet Gynecol 2016;215:589.e1-e6.
12. Yan L, Li M, Zhang B-Q, Xu XX, Xu Z, Han T, et al. Effect of ovarian dermoid cyst excision on ovarian reserve and response: Insights from in vitro fertilization. Gynecology and Minimally Invasive Therapy 2016;5:161-5.
13. Lind T, Hammarström M, Lampic C, Rodriguez‐Wallberg K. Antimüllerian hormone reduction after ovarian cyst surgery is dependent on the histological cyst type and preoperative anti‐müllerian hormone levels. Acta Obstet Gynecol Scand 2015;94:183-90.
14. Dogan E, Ulukus EC, Okyay E, Ertugrul C, Saygili U, Koyuncuoglu M. Retrospective analysis of follicle loss after laparoscopic excision of endometrioma compared with benign nonendometriotic ovarian cysts. Int J Gynecol Obstet 2011;114:124-7.
15. Cagnacci A, Bellafronte M, Xholli A, Palma F, Carbone MM, Di Carlo C, et al. Impact of laparoscopic cystectomy of endometriotic and non-endometriotic cysts on ovarian volume, antral follicle count (AFC) and ovarian doppler velocimetry. Gynecol Endocrinol 2016;32:298-301.
16. Guerriero S, Ajossa S, Mais V, Risalvato A, Lai MP, Melis GB. The diagnosis of endometriomas using colour Doppler energy imaging. Hum Reprod 1998;13:1691-5.
17. Moore J, Copley S, Morris J, Lindsell D, Golding S, Kennedy S. A systematic review of the accuracy of ultrasound in the diagnosis of endometriosis. Ultrasound Obstet Gynecol 2002;20:630-4.
18. Patel MD, Feldstein VA, Chen DC, Lipson SD, Filly RA. Endometriomas: diagnostic performance of US. Radiology 1999;210:739-45.
19. Mais V, Guerriero S, Ajossa S, Angiolucci M, Paoletti AM, Melis GB. Transvaginal ultrasonography in the diagnosis of cystic teratoma. Obstet Gynecol 1995;85:48-52.
20. Patel MD, Feldstein VA, Lipson SD, Chen DC, Filly RA. Cystic teratomas of the ovary: diagnostic value of sonography. AJR American journal of roentgenology 1998;171:1061-5.
21. Hudelist G, English J, Thomas A, Tinelli A, Singer C, Keckstein J. Diagnostic accuracy of transvaginal ultrasound for non‐invasive diagnosis of bowel endometriosis: systematic review and metaanalysis. Ultrasound Obstet Gynecol 2011;37:257-63.
22. Streuli I, de Ziegler D, Gayet V, Santulli P, Bijaoui G, de Mouzon J, et al. In women with endometriosis anti-Müllerian hormone levels are decreased only in those with previous endometrioma surgery. Hum Reprod 2012;27:3294-303.
23. Uncu G, Kasapoglu I, Ozerkan K, Seyhan A, Oral Yilmaztepe A, Ata B. Prospective assessment of the impact of endometriomas and their removal on ovarian reserve and determinants of the rate of decline in ovarian reserve. Hum Reprod 2013;28:2140-5.
24. Pacchiarotti A, Frati P, Milazzo GN, Catalano A, Gentile V, Moscarini M. Evaluation of serum anti-Mullerian hormone levels to assess the ovarian reserve in women with severe endometriosis. Eur J Obstet Gynecol Reprod Biol 2014;172:62-4.
25. Kim JY, Jee BC, Suh CS, Kim SH. Preoperative serum anti-mullerian hormone level in women with ovarian endometrioma and mature cystic teratoma. Yonsei Med J 2013;54:921-6.
26. Chang HJ, Han SH, Lee JR, Jee BC, Lee BI, Suh CS, et al. Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels. Fertility and Sterility 2010;94:343- 9.
27. Muzii L, Bianchi A, Crocè C, Manci N, Panici PB. Laparoscopic excision of ovarian cysts: is the stripping technique a tissue-sparing procedure? Fertil Steril 2002;77:609-14.

APA	karadağ c, demircan s, Turgut A, Caliskan E (2020). Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. , 15 - 20. 10.4274/tjod.galenos.2020.37605
Chicago	karadağ cihan,demircan sinem,Turgut Abdulkadir,Caliskan Eray Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. (2020): 15 - 20. 10.4274/tjod.galenos.2020.37605
MLA	karadağ cihan,demircan sinem,Turgut Abdulkadir,Caliskan Eray Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. , 2020, ss.15 - 20. 10.4274/tjod.galenos.2020.37605
AMA	karadağ c,demircan s,Turgut A,Caliskan E Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. . 2020; 15 - 20. 10.4274/tjod.galenos.2020.37605
Vancouver	karadağ c,demircan s,Turgut A,Caliskan E Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. . 2020; 15 - 20. 10.4274/tjod.galenos.2020.37605
IEEE	karadağ c,demircan s,Turgut A,Caliskan E "Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst." , ss.15 - 20, 2020. 10.4274/tjod.galenos.2020.37605
ISNAD	karadağ, cihan vd. "Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst". (2020), 15-20. https://doi.org/10.4274/tjod.galenos.2020.37605

APA	karadağ c, demircan s, Turgut A, Caliskan E (2020). Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. Turkish Journal of Obstetrics and Gynecology, 17(1), 15 - 20. 10.4274/tjod.galenos.2020.37605
Chicago	karadağ cihan,demircan sinem,Turgut Abdulkadir,Caliskan Eray Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. Turkish Journal of Obstetrics and Gynecology 17, no.1 (2020): 15 - 20. 10.4274/tjod.galenos.2020.37605
MLA	karadağ cihan,demircan sinem,Turgut Abdulkadir,Caliskan Eray Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. Turkish Journal of Obstetrics and Gynecology, vol.17, no.1, 2020, ss.15 - 20. 10.4274/tjod.galenos.2020.37605
AMA	karadağ c,demircan s,Turgut A,Caliskan E Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. Turkish Journal of Obstetrics and Gynecology. 2020; 17(1): 15 - 20. 10.4274/tjod.galenos.2020.37605
Vancouver	karadağ c,demircan s,Turgut A,Caliskan E Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. Turkish Journal of Obstetrics and Gynecology. 2020; 17(1): 15 - 20. 10.4274/tjod.galenos.2020.37605
IEEE	karadağ c,demircan s,Turgut A,Caliskan E "Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst." Turkish Journal of Obstetrics and Gynecology, 17, ss.15 - 20, 2020. 10.4274/tjod.galenos.2020.37605
ISNAD	karadağ, cihan vd. "Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst". Turkish Journal of Obstetrics and Gynecology 17/1 (2020), 15-20. https://doi.org/10.4274/tjod.galenos.2020.37605