Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Objectives:The current study is designed to explore the impact of laparoscopic ovarian cystectomy versus aspiration and coagulation on ovarian reserve and pelvic pain in cases of ovarian endometrioma. Design: Randomized controlled prospective study. Setting: Obstetrics and Gynecology department, Kasr El-Ainy Hospital. Patients: Ninety two patients presenting with unilateral ovarian endometrioma. Interventions: FSH, LH, E2, AMH, AFC (antral follicular count) and chronic pelvic pain{assessed by Visual Analogue Scale (VAS)} ;all were determined before and after laparoscopic surgery (postoperative three months); for two groups (Group A) cystectomy and (Group B) aspiration and coagulation, performed randomly using closed envelope.Histopathological examination was done to the cystectomy group to confirm endometriosis and detect the presence of healthy ovarian tissue in the excised cyst wall. Main outcome measure: A comparison between the impact of laparoscopic ovarian cystectomy versus aspiration and coagulation on ovarian reserve.Results:There was postoperative significant decrease in (FSH, LH, E2, AMH) and AFC in each group compared with the preoperative values but were within normal ranges and this decrease was of no statistically significant difference between both groups as regarding (FSH, LH, E2, AMH).Although there was a statistically significant difference between both groups in AFC which was more decreased in the cystectomy group. So, AFC was more accurate in predicting ovarian reserve loss than AMH.As regard postoperative chronic pelvic pain; it was improved in both groups with a statistically highly significant difference but the improvement was more marked in the cystectomy group

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