Effect of Two Laparoscopic Techniques for Treatment of XXXX on Ovarian Reserve.

@entity1 @entity43 @entity249 @entity45 @entity158 @entity2670
INTRODUCTION: Operative laparoscopy is the most common used technique for treatment of @entity1 with @entity43 , because of many positive effects in comparison with laparotomy. There are many laparoscopic techniques, but most used are cystectomy and puncture with endocoagulation (ablation) of the cyst's capsule. The aim of this study was to evaluate the effect of two laparoscopic techniques for treatment of @entity43 on ovarian reserve. We used two ultrasonographic markers for ovarian reserve: ovarian volume and antral follicle count (AFC). MATERIALS AND METHODS: Sixty @entity1 in reproductive age (18-42 years) were treated for a chronic pelvic @entity158 or @entity249 in a tertiary hospital (University Clinic for Gynecology and Obstetrics in Skopje, R. Macedonia). The study was prospective and two laparoscopic techniques were used. All @entity1 were with confirmed ultrasound diagnosis for @entity43 with diameter between 3 and 8 cm. Complete cystectomy was done in 30 @entity1 (group A) and puncture with endocoagulation was done in other 30 @entity1 (group B). Ovarian reserve was analyzed before surgery and was controlled one and three months after laparoscopic surgery. RESULTS: In group A (operated with cystectomy) ovarian volume was 53.46  29.97 cm   before surgery, which fell to 13.06  7.34 cm   after one month, and 13.28  7.17 cm   after three months. Statistical analysis showed a significant @entity2670 and three months after surgery (p <=0.01). In group B (operated with puncture and endocoagulation) the ovarian volume was 58.34  37.99 cm   before surgery, which fell to 18.96  7.90 cm   one month and 17.38  6.86 cm   three months after surgery. In both groups there was a significant @entity2670 and three months postoperatively (p <=0.01). In the first group AFC was 3.03  1.27 before surgery, 4.8  1.30 one month after surgery and 6.23  1.57 after three months. Statistical analysis showed a significant increase in AFC after laparoscopic cystectomy (p <=0.01). In the second group AFC was 3.07  1.05 before surgery, 5.33  1.60 after one month and 7.0  1.62 after three months. The comparison of AFC showed high statistically significant difference (p <=0.001), e.g. increase of AFC after one and three months in comparison with AFC before surgery. CONCLUSIONS: Ovarian reserve decreases after laparoscopic surgery using both laparoscopic techniques. But, this decrease was more frequent using cystectomy in comparison with ablation of the @entity45 .
