Bipolar Electrocoagulation versus Suture of Solitary Ovary after Laparoscopic Excision of Ovarian Endometriomas

Abstract

Study Objective To compare the functional ovarian damage associated with the use of bipolar coagulation versus ovarian suture after laparoscopic excision of ovarian endometriomas in patients with a solitary ovary. Design Retrospective study (Canadian Task Force classification II-3). Setting Tertiary care center. Patients Forty-seven consecutive women with a single ovary and regular menses who underwent laparoscopic stripping of one or more ovarian endometriomas between June 1996 and June 2001. Intervention Twenty-one patients had bipolar electrocoagulation (group A), while 26 had suturing of the ovary (group B). Plasma follicle-stimulating hormone (FSH) and estradiol levels were determined before surgery and re-evaluated at 3-, 6-, and 12-month follow-up. Measurements and Main Results At 12-month follow-up, six patients (29%) in group A had oligo-amenorrhea versus three patients (12%) in group B (p = .14). Follicle-stimulating hormone levels between 10 and 20 mIU/mL were found in five patients (24%) in group A and in three patients (12%) in group B, whereas FSH levels above 20 mIU/mL were found in three patients (14%) in group A and in no patient in group B. Eight patients (38%) in group A had FSH levels greater than 10 mIU/mL versus three patients (12%) in group B (p = .042). Overall, repeated analysis of variance showed a marginally significant difference (p = .06) in FSH values between the two groups. Conclusion Our results suggest that bipolar electrocoagulation of the ovarian parenchyma after laparoscopic stripping of an endometriotic ovarian cyst adversely affects ovarian function.