Dabirashrafi, H., Mohamad, K., Behjatnia, Y., & Moghadami-Tabrizi, N. (1991). Adhesion formation after ovarian electrocauterization on patients with polycystic ovarian syndrome. Fertility and Sterility, 55(6), 1200-1201. https://doi.org/10.1016/s0015-0282(16)54377-5
Dabirashrafi H, Mohamad K, Behjatnia Y, Moghadami-Tabrizi N. Adhesion formation after ovarian electrocauterization on patients with polycystic ovarian syndrome. Fertil Steril. 1991;55(6):1200-1201. doi:10.1016/s0015-0282(16)54377-5
Dabirashrafi, Hormoz, et al. "Adhesion formation after ovarian electrocauterization on patients with polycystic ovarian syndrome." Fertility and Sterility, vol. 55, no. 6, 1991, pp. 1200-1201.
For EndNote, Zotero or Mendeley:
Open access
Free to read
No reuse license
Free to read at the publisher (reported by Unpaywall and OpenAlex, not verified by RRM Academy)
Second look after PCOS electrocautery found mostly minimal adhesions
In a surgical series, second-look surgery found adhesions on 5 of 25 cauterized ovaries, 4 of them minimal. The women had polyendocrine metabolic ovarian syndrome (PMOS), formerly polycystic ovary syndrome (PCOS). The first group of 21 was re-examined 60 to 70 days after electrocautery. A second group of 8, re-examined 8 to 24 months later, had none in 16 ovaries.
Key Findings
In the unselective group, 21 women all had second-look laparoscopy 60 to 70 days after surgery, which found 5 adnexal adhesions among 25 ovaries that had been cauterized.
Of the 5 adhesions, 4 were from the minimal class and 1 was from the moderate class.
In the selective group of 17 women who had benefited from the operation, 8 had a further operation 8 to 24 months later, with no adhesion in their 16 ovaries.
In 7 women, one ovary had laparotomy electrocautery and the other had macrosurgical ovarian wedge resection. One cauterized ovary had a minimal adhesion, and all 7 wedge-resected ovaries showed adhesion formation.
Interpretation
This short communication covers two groups of women with PMOS / PCOS who had ovarian electrocautery. The authors identify the unselective group, in which every woman had a second-look laparoscopy, as the one that gives the actual rate of adhesion formation. The surgeon at second look did not know which technique had been used. The authors note that this result cannot be extended to women who have this operation in general. Based on these results, they do not recommend routine second-look laparoscopy for patients who had previous ovarian electrocautery. The findings support further study of adhesion prevention after ovarian surgery.
RRM Context
Restorative reproductive medicine surgery counts adhesion prevention as part of the operation. The operations in this series ended with no special solution in the abdomen. In a randomized study of 55 patients with bilateral ovarian disease, one ovary was wrapped in an absorbable barrier and one was left bare. Of 55 wrapped ovaries, 26 had no adhesions at second look. Of 55 bare ovaries, 14 had none (Franklin 1995).
Our editorial summary of this paper, not the article's abstract.
Abstract
The rate of adhesion formation after ovarian electrocauterization has been described in two selective and unselective groups of patients with PCOS. The rate of this complication in the selective group was 0 from 16 ovaries and in the unselective group (5/25). However, the rate of major adnexal adhesion in the unselective group was 1 from 25 ovaries.
How fertility-preserving surgery differs by approach: restorative (RRM), specialist, and conventional, across endometriosis, ovarian cysts, PMOS / PCOS, fibroids, tubal disease, Asherman's syndrome, adenomyosis, cesarean scar, pelvic adhesions, and male-factor causes including varicocele and obstruction.
PMOS / PCOS has four diagnostic phenotypes and distinct metabolic, reproductive, and mental health implications. How RRM-trained clinicians approach diagnosis and treatment differently.
05vf56z40 