The effect of laparoscopic treatment of polycystic ovarian disease by CO2-laser or Nd:YAG laser.

Abstract

The feasibility and efficacy of laparoscopic CO2 laser and Nd:YAG non-contact laser application for the treatment of polycystic ovarian disease (PCOD) were evaluated in 30 patients (19 patients treated with the CO2 laser, and 11 with the Nd:YAG laser). The criteria for inclusion of PCOD in our study were: amenorrhea or oligomenorrhea with chronic anovulation, failure to ovulate in response to clomide or human menopausal gonadotropin, elevated serum levels of luteinizing hormone (LH) or an elevated LH/follicle-stimulating hormone ratio, exaggerated LH response to gonadotrophin-releasing hormone (GnRH), elevated serum androgen levels, and ultrasonographic features of polycystic ovaries. Eight pregnancies after CO2 laser and three after Nd:YAG laser were achieved. Decline of serum androgen concentrations was noted in both groups, but was significantly higher in the Nd:YAG laser group (from 3.4 +/- 0.4 ng/ml to 2.2 +/- 0.2 ng/ml). Nine patients checked before and after laser treatment showed a decrease in the characteristically exaggerated pituitary response to exogenous GnRH injection. There were no consistent findings of the pattern in LH pulsatility studied in 5 patients after Nd:YAG laser treatment. Ovarian status was investigated in 11 patients by second-look laparoscopy or cesarian section. There were absolutely no adhesions after Nd:YAG laser coagulation. Filmy adhesions were seen in 3 patients in the CO2 laser group.

• Authors: G Keckstein, W Rossmanith, K Spatzier, V Schneider, K Börchers, R Steiner
• Journal: Surgical endoscopy (Surg Endosc) Vol. 4 Issue 2 Pg. 103-7 ( 1990) ISSN: 0930-2794 [Print] Germany
• PMID: 2142827 (Publication Type: Journal Article)

Chemical References

• Testosterone
• Androstenedione
• Luteinizing Hormone

Topics

• Amenorrhea (etiology)
• Androstenedione (metabolism)
• Female
• Humans
• Infertility, Female (etiology, surgery)
• Laparoscopy (adverse effects, methods)
• Laser Therapy (adverse effects, methods)
• Luteinizing Hormone (metabolism)
• Menstrual Cycle
• Oligomenorrhea (etiology)
• Ovarian Diseases (etiology)
• Ovulation (physiology)
• Polycystic Ovary Syndrome (complications, surgery)
• Testosterone (metabolism)
• Tissue Adhesions (etiology)