• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

Hemostatic Sealant vs Electrocoagulation Following Laparoscopic Endometrioma Cystectomy: Effect on Ovarian Reserve

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Previous studies comparing hemostatic techniques used AMH to assess ovarian reserve, which may not be as accurate as antral follicle count (AFC)
    • Hormone secretion by non-operated ovary may mask reduced reserve of ovary undergoing surgery
  • Chung et al. (BJOG, 2019) evaluated the effect of hemostatic sealant compared to bipolar coagulation on ovarian reserve following laparoscopic cystectomy using AFC

METHODS:

  • Randomized controlled trial (RCT)
    • Participants and sonographers were blinded to exposure
  • Participants
    • Women aged 18-40 years
    • 3–8 cm unilateral or bilateral endometriomas
    • No previous surgery or history of hormonal therapy 6 months prior to surgery
  • Surgery
    • Laparoscopic cystectomy using the ‘stripping method’
  • Exposures
    • Hemostasis by the application of hemostatic sealant (FloSeal)
    • Standard care (bipolar coagulation)
  • Primary outcomes
    • Change in AFC 3 months after the operation
  • Secondary outcomes
    • Change in AMH and FSH
    • Peri-operative outcomes: Hemostasis | Complications | Pain | Satisfaction scores

RESULTS:

  • 94 patients: 47 in each group
    • Mean age:  32.36 years
    • Mean endometrioma diameter: 4.21 cm

Primary outcome: AFC

  • In both groups, AFC at 1 and 3 months post-op were both higher than baseline
  • There was a significantly greater increase in AFC with hemostatic sealant group at 3 months (P = 0.013)
    • Sealant (mean and SD): +2.36 ± 0.37
    • Control: +1.08 ± 0.36
    • Unoperated ovary: No change in AFC
  • There was no significant difference between the groups for
    • AMH and FSH
    • Operative details (time, blood loss) | Postoperative complications | Recovery | Pain scores

CONCLUSION:

  • While impact of sealant is modest, may be clinically important, especially for women who may be at risk for ovarian reserve compromise such as older women
  • Hemostatic sealant should be considered as an alternative to bipolar coagulation for laparoscopic cystectomy for endometriosis

Learn More – Primary Sources:

Impact of haemostatic sealant versus electrocoagulation on ovarian reserve after laparoscopic ovarian cystectomy of ovarian endometriomas: a randomised controlled trial

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

Learn More  »

image_pdfFavoriteLoadingFavorite
< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

Does Vasopressin Injection Reduce Risk of Reduced Ovarian Reserve During Surgery for Bilateral Endometriomas?
Infertility Evaluation: Who, When and How
Do AMH Levels Truly Predict Ovarian Reserve in Women Over 30?
Results from the LAROSE Study: Robotic Surgery vs Laparoscopy for Endometriosis
Does the Oral GnRH Antagonist Elagolix Improve Endometriosis-Associated Pain?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Log In to ObG First

Please log in to access OBGFirst and the 2T Ultrasound Atlas

Password Trouble?

Sign Up for ObGFirst

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!

ObG First Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site