PMOS / PCOS Surgical Treatment

Long-term clinical effects of ovarian wedge resection in polycystic ovarian syndrome

Hjortrup A, Kehlet H, Lockwood K, Hasner E

Acta Obstetricia Et Gynecologica Scandinavica, 62(1), 55-57, 1983
DOI 10.3109/00016348309155759 PMID 6858626

RRM Academy Synopsis

Wedge resection restored regular periods in 26 of 29 women with PCOS

In a 1983 Danish case series of 29 women with polycystic ovary syndrome (PCOS, now PMOS, Polyendocrine Metabolic Ovarian Syndrome), ovarian wedge resection restored regular periods in 26 women, about 9 out of 10. Ten of the 13 women who tried to conceive got pregnant. Follow-up averaged 5.7 years. Hirsutism stayed largely unchanged.

Key Findings

  • In this series, 26 of 29 women (90%) had regular menstrual cycles after wedge resection. Three still had infrequent periods (oligomenorrhea) and none had amenorrhea.
  • Thirteen women attempted pregnancy and 10 became pregnant, one of whom had an abortion. All 3 who did not conceive still had infrequent periods.
  • Eight of 9 obese women with normal postoperative cycles lost weight. Two of the 3 women with infrequent periods were obese and had no major weight change.
  • Hirsutism regressed slightly in 2 women and stayed unchanged in the other 27.
  • The authors report no complications and no ectopic pregnancy. One woman's periods became infrequent again 11 months after surgery, and she kept normal cycles after a second resection.

Interpretation

This case series followed 29 women with hirsutism and irregular or absent periods for 2.3 to 9.5 years. The authors first ruled out other causes, such as Cushing's syndrome and adrenal gland problems. They then did ovarian wedge resection surgery. The team reports no complications and no ectopic pregnancy. The pregnancies that followed lead them to believe scar tissue was probably not a major problem. The findings support larger studies of wedge resection for women with PCOS and irregular cycles.

RRM Context

Restorative reproductive medicine aims to restore ovulation and treat the cause of a cycle problem. This 1983 study looked at periods and pregnancy after ovarian surgery.

Abstract

Twenty-nine consecutive patients with polycystic ovary (PCO) syndrome (defined as hirsutism plus oligomenorrhea or secondary amenorrhea, and excluding Cushing's syndrome, an androgen-secreting adrenal or ovarian tumor or adrenocortical hyperplasia) were treated with ovarian wedge resection leaving normal-sized ovaries. Long-term follow-up from 2.3-9.5 years (mean 5.7 years) showed that 26 of 29 patients (90%) had established normal menstrual cycles. Fertility and normal pregnancies were achieved in all 10 patients (100%) with normal postoperative menstrual cycles who desired to conceive, but not in the 3 patients with remaining postoperative oligomenorrhea. Eight of 9 patients who were obese preoperatively and who had normal postoperative menstrual cycles showed a major weight loss after wedge resection. In contrast, none of the preoperatively obese patients, who remained oligomenorrheic after surgery, lost weight. Hirsutism was not cured by wedge resection. It is concluded that ovarian wedge resection should still be considered useful in patients with PCO.

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Topics

Related research

PMOS / PCOS › Surgical Treatment › Ovarian Wedge Resection · Reproductive Surgery › Ovarian Surgery › Ovarian Reserve Preservation · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances
PMID 6858626 6858626 DOI 10.3109/00016348309155759 10.3109/00016348309155759 Hjortrup et al. 1983, Hjortrup 1983