Abstract
BackgroundTo develop a minimally invasive ovarian cauterization technique under transvaginal ultrasound control and evaluate the safety and feasability of monopolar cauterization to cause ovarian injury using female cattle of reproductive age as an experimental model.MethodExperimental study in a university research center was performed. Eleven female bovines of reproductive age were submitted to monopolar transvaginal ovarian cauterization. The right ovary (RO) was punctured at four sites and 40 W was applied for 5 s at each point, resulting in a total of 800 J (Joules) of thermal energy. In the left ovary (LO), the procedure was similar, with the same time and 80 W, resulting in a thermal energy of 1600 J. Macroscopic and microscopic lesions were assessed.ResultsOf 22 ovaries punctured, 20 were cauterized and exhibited macroscopic and typical microscopic lesions. No lesions could be found in the needle path. The measures of the areas of microscopic electrocautery lesions calculated estimating a cylindrical volume showed a median of 1.12% in the right ovary and 1.65% in the left ovary. When the estimate was calculated by spherical shape, the medians were 1.77% in the right ovary and 3.06% in the left ovary. There was a statistically significant difference in these two estimates (sphere, p = 0.008; cylinder, p = 0.021).ConclusionThe experimental animal model described for transvaginal ultrasound-guided ovarian needle cauterization seems to be feasible. The ovaries were successfully cauterized without injuries in needle path and more energy resulted in significantly more thermal lesion. The safety and effectiveness of this technique, theoretically less invasive than current ovarian drilling methods, could be tested in anovulatory women with PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is a multifactorial syndrome characterized by at least two of the following three changes: anovulation, hyperandrogenism, and enlarged ovaries on ultrasound [1,2]
The measures of the areas of microscopic electrocautery lesions calculated estimating a cylindrical volume showed a median of 1.12% in the right ovary and 1.65% in the left ovary
When the estimate was calculated by spherical shape, the medians were 1.77% in the right ovary and 3.06% in the left ovary
Summary
Polycystic ovary syndrome (PCOS) is a multifactorial syndrome characterized by at least two of the following three changes: anovulation, hyperandrogenism, and enlarged ovaries on ultrasound [1,2]. The latest consensus on treatment of PCOSrelated infertility, published in 2008, advocates the use Laparoscopic ovarian diathermy (LOD) is associated with high rates of ovulation (80% to 90%) and pregnancy (60% to 80%) [5,7,8]. LOD is an inpatient treatment, requires general anesthesia, and the risk of postoperative adhesions cannot be ignored [8,10]. Seeking to reduce adhesions and simplify ovarian cauterization, microlaparoscopy without general anesthesia [11] and laser-based transvaginal ovarian drilling (TVOD) techniques have been described [11,12,13,14]. To develop a minimally invasive ovarian cauterization technique under transvaginal ultrasound control and evaluate the safety and feasability of monopolar cauterization to cause ovarian injury using female cattle of reproductive age as an experimental model
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.