Aim: To determine the effects of using suturing hemostasis in cases of cystectomy of unilateral endometriomas and mature teratomas (MT).
Introduction: Nowadays there is a noticeably growing rate of benign ovarian tumors requiring urgent treatment. It is known that ovarian tumors lead to diminished ovarian reserve (OR). Conserving surgeries bring to a further reduction of OR.
Methods: The study involved 66 patients with endometriomas and 69 with MT. The mean age was 28.07±5.3. All patients underwent laparoscopic cystectomy. The methods to stop bleeding were: ligature hemostasis with absorbable polyglycolic suture, USP 2-0 (I group) and bipolar coagulation (BPC) – Autcon II 350, current power 35W – (II group). Before and 6–12 months after surgery serum levels of Antimüllerian hormone (AMH) were evaluated; by ultrasound (Toshiba Aplio 500, 3.6–8.8MHz) we measured the volume of healthy ovarian tissue (Vcm3), antral follicle count (AFC), their site and diameter.
Results: At the pre-surgical stage patients with endometriomas had reasonably lower ultrasound and biochemical markers than patients with MT. 6 months after suturing hemostasis patients with endometriomas had a 1.8 times higher AFC, its diameter and, as a result, the volume of ovarian tissue of the operated gonad compared to the group after BPC. Studying similar indices by the patients with MT showed the difference of 1.3 times respectively. Deformed follicles with small diameter (3–4mm) ousted to the periphery were located on the echograms. Six months after laparoscopy the AMH level of all patients decreased, the biggest reduction (1.7 and 1.9 times correspondingly to groups) was noted by the patients with endometriomas.
Conclusion: To preserve women's reproductive potential after conserving surgeries on the ovaries, intracorporeal suturing is a preferred hemostatic method over bipolar energy. Enucleation of endometriomas and MT leads to diminished OR regardless of the energy type used as a hemostasis.