Monopolar versus bipolar laparoscopic ovarian drilling in clomiphene-resistant polycystic ovaries (PCO): a preliminary study
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- 作者：Atef M. Darwish ; AboBakr Metwally ; Mammdoh M. Shaaban…
- 刊名：Gynecological Surgery
- 出版年：2016
- 出版时间：August 2016
- 年：2016
- 卷：13
- 期：3
- 页码：179-185
- 全文大小：421 KB
- 刊物主题：Gynecology; Minimally Invasive Surgery; Surgical Oncology; Obstetrics/Perinatology; Reproductive Medicine; Interventional Radiology;
- 出版者：Springer Berlin Heidelberg
- ISSN：1613-2084
- 卷排序：13
文摘
The objective of this study is to compare the safety and efficacy of laparoscopic ovarian drilling (LOD) utilizing monopolar versus bipolar needle in clomiphene-resistant polycystic ovaries (PCO) in infertile women. This study is a prospective randomized comparative diagnostic trial. The procedures were performed in an endoscopic unit of a tertiary care referral facility and university hospital. Eighty clomiphene-resistant PCO patients were randomly assigned by using a computerized random table into group A and group B for monopolar and bipolar LOD of 40 patients in each group, respectively. The intervention was LOD using monopolar or bipolar needle in groups A and B, respectively. The main outcome measures are resumption of regular menstruation, spontaneous ovulation, and pregnancy. Both groups showed a significant postoperative improvement of menstrual patterns and hormonal profiles if compared to preoperative levels without significant difference between both groups. Spontaneous ovulation resumed in 13 (32.5 %) and 25 (62 %), p = 0.007, while spontaneous pregnancy within 1 year after LOD occurred in 9 (22.5 %) and 18 (45 %) cases (p = 0.033) in both groups, respectively. Both monopolar and bipolar needles are effective tools for LOD in clomiphene citrate (CC)-resistant PCO infertile patients as a second-line therapy. Utilizing bipolar LOD is superior to monopolar LOD due to a significantly higher postoperative incidence of resumption of spontaneous ovulation and spontaneous pregnancy. Theoretical less adhesion formation following bipolar LOD requires a second-look laparoscopy study. In the meantime, spread of bipolar LOD should be encouraged.KeywordsLaparoscopic ovarian drillingPolycystic ovariesClomiphene citrate