Stein-Leventhal syndrome

Halbe HW; da Fonseca AM; de Paula e Silva P; Clauzet RB; Galluci J

doi:10.1016/0002-9378(72)90079-8

PMOS / PCOS · Surgical Treatment

Stein-Leventhal syndrome

Halbe HW, da Fonseca AM, de Paula e Silva P, Clauzet RB, Galluci J

Published September 15, 1972 American Journal of Obstetrics and Gynecology, 114(2), 280-281

DOI 10.1016/0002-9378(72)90079-8 PMID 4673811

RRM Academy Synopsis

Larger Wedge Resection Tied to Better Stein-Leventhal Outcomes

Women with the largest ovarian wedge removed had the most regular periods and pregnancies. In this 1972 case series, 62 women with Stein-Leventhal syndrome had surgery. The condition is now called PCOS, or PMOS (Polyendocrine Metabolic Ovarian Syndrome). Pregnancy counts cover the 38 married women.

About 7 in 10 women with Stein-Leventhal syndrome had regular periods after ovarian wedge resection. Source: Halbe HW et al., 1972, PMID 4673811.

Study at a glance, 1972 case series of 62 women: Women with the largest ovarian wedge removed had the most regular periods. Source: Halbe HW et al., 1972, PMID 4673811.

Key Findings

62 women with Stein-Leventhal syndrome had ovarian wedge resections of three sizes: no more than 1%, about a third, and up to three-quarters of the ovary.
Regular menstrual periods returned in 53.3% of the smallest-wedge group, 70.8% of the middle group, and 91.3% of the largest-wedge group (average 74.1%).
Among the 38 women who married, pregnancy occurred in 50.0% of the smallest-wedge group, 52.9% of the middle group, and 92.3% of the largest (average 65.7%).
The difference across groups was statistically significant for menstrual outcome (chi-square 7.083, p < 0.05) and for pregnancy outcome (chi-square 6.195, p < 0.05).
Women were followed for a year or more after surgery; 38 of the 62 were married before or after the procedure.

Interpretation

This is a short 1972 letter reporting a small study the authors ran. They say wedge size was chosen at random but do not describe how. They then sorted the 62 women into three groups by how much tissue was actually removed. Each group was likely small. Pregnancy rates cover only the 38 women who married. The authors give no follow-up beyond a year or more. A link between wedge size and outcome is not proof that removing more tissue caused the better results. Other differences between the groups could explain the pattern.

RRM Context

Stein-Leventhal syndrome is an old name. Doctors now call this condition polycystic ovary syndrome (PCOS), or PMOS. From the 1960s into the 1970s, bilateral ovarian wedge resection was the standard surgery for it. Doctors later replaced this surgery with laparoscopic ovarian drilling. Open wedge resection carries a high risk of pelvic scar tissue. RRM clinicians may see this older surgery in a patient's history. This letter shows one documented effect it had on periods and pregnancy.

Our editorial summary of this paper, not the article's abstract.

Abstract not indexed.

Topics

PMOS / PCOS › Surgical Treatment › Ovarian Wedge Resection · Reproductive Surgery › Ovarian Surgery › Ovarian Reserve Preservation · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances

A M da Fonseca, P de Paula e Silva

PMID 4673811 4673811 DOI 10.1016/0002-9378(72)90079-8 10.1016/0002-9378(72)90079-8 Halbe et al. 1972, Halbe 1972

Keywords

Female, Humans, Infertility, Female/therapy, Menstruation, Polycystic Ovary Syndrome/surgery, Pregnancy

Stein-Leventhal syndrome

Larger Wedge Resection Tied to Better Stein-Leventhal Outcomes

Key Findings

Interpretation

RRM Context

Topics

Related research

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

Polycystic ovary syndrome: a changing perspective

Chapter 43: Polycystic Ovarian Disease

Amenorrhea Associated with Bilateral Polycystic Ovaries

Keywords