Gynecological diseases occur in almost every second woman. Among them, polycystic ovaries are quite common. This pathology does not apply to infectious diseases. Therefore, they cannot be infected. In addition, this disease occurs only among women. In some cases, the pathology is formed even in adolescence. Sometimes the disease is congenital. One of the methods of treatment is laparoscopy for polycystic ovaries. Reviews about this procedure are different. After all, it belongs to one of the types of surgical interventions. Therefore, some women prefer to use other methods of treatment. However, according to doctors, sometimes this operation is necessary.
What is PCOS?
Polycystic ovaries refers to hormonal pathologies. The disease can be congenital and acquired during life (more often in adulthood). In the first case, it is genetically determined, that is, it is formed in the embryonicperiod. Nevertheless, congenital polycystic disease is diagnosed only in adolescence. Until this time, the pathology does not manifest itself in any way. Acquired polycystic ovaries often develops against the background of endocrine disorders. These include diabetes, obesity, adrenal or thyroid disease. Sometimes polycystosis is formed after brain injuries, long-term use of hormonal drugs. The mechanism of development of this pathology consists in the following changes:
- Decreased production of estrogen and progesterone. Increasing the level of male sex hormones - androgens.
- Thickening of the ovarian tunic. As a result of this, the follicles are not destroyed, and the egg does not come out. Due to ovulation disorders, infertility develops.
- Filling follicles with fluid and forming cysts.
Such changes occur if the pathology is acquired. In this case, the condition is called polycystic ovary syndrome (PCOS). Its symptoms include: weight gain, hypertrichosis, infertility. Signs of congenital pathology are the underdevelopment of the "female appearance" (narrow pelvis, poorly formed mammary glands), acne, oligomenorrhea.
Laparoscopy for polycystic disease
Laparoscopy for polycystic ovaries refers to surgical methods of treatment. It is used in cases where drug therapy does not help. This method of removing cysts from the ovaries is considered the most effective. In addition, compared to opensurgical intervention laparoscopy is less traumatic. Other benefits include:
- Reduce the risk of complications.
- Shortening the postoperative period.
- Quick recovery.
- Minimum aesthetic defects (compared to open abdominal surgery).
Despite the obvious advantages of the method, there is still debate: is it worth doing laparoscopy for polycystic ovaries? After all, some doctors advise women to start trying drug therapy. In fact, in some cases, conservative treatment helps to cope with polycystic disease. In order to restore the functions of the ovaries, therapy with female sex hormones is used. Medications that block the synthesis of androgens are also prescribed. However, drugs are not always effective. Especially in the case of an acquired disease. Therefore, if no effect is observed after a course of drug treatment, laparoscopy is recommended for polycystic ovaries. This method means the removal of liquid formations from the organ cavity using special surgical equipment. Incisions during laparoscopy are minimal, so they do not leave a cosmetic defect after healing. In most cases, this method helps to get rid of such a severe symptom as female infertility.
Varieties of laparoscopy for polycystic ovaries
Laparoscopy for polycystic ovaries can be performed in several ways. It dependson the goal pursued by the surgeon, as well as the technical capabilities of the medical institution. Like all similar surgical interventions, ovarian laparoscopy can be diagnostic and therapeutic. The first is carried out with suspicion of polycystic disease, when the pathology has not yet been identified with accuracy. Often, diagnostic laparoscopy turns into therapeutic manipulation. The second, in turn, is divided into several options. Among them:
- Decortization of the ovaries. This type of therapeutic laparoscopy consists in removing the upper shell of the organ. Due to decortization, the surface layer becomes thinner, allowing the maturation and rupture of the follicles.
- Cauterization of cysts. A similar method of treatment is performed using laser equipment. The operation consists in making several incisions on the surface of the ovary. The result is the opening of the cysts and the removal of their contents. After some time, the normal tissue of the organ is restored.
- Resection of the ovary. It is characterized by the removal of the part of the organ in which the cysts are located. This method cannot be used if fluid formations are located over the entire surface of the ovary.
- Electrothermocoagulation. This variant of therapeutic laparoscopy is the execution of punctures of the organ in places of cystic formations. At the same time, the ovary is coagulated to avoid bleeding.
- Electrodrilling. It consists in the effect of current on the area of cysts. The contents of the formations are deleted.
All of the listed laparoscopy options are consideredefficient. The difference between them is that not every procedure is performed in a particular clinic. Some of the treatments are considered expensive and are only available in specialized medical organizations.
Preparing for surgery
Laparoscopy does not require complex preparation. However, certain rules must be observed before the operation. First of all, a number of diagnostic studies are performed a few days before laparoscopy. These include: KLA, a blood test for HIV infection, syphilis and hepatitis. A urine test is also performed to rule out kidney disease. In addition, important laboratory diagnostic procedures are: a biochemical blood test and a coagulogram. One day before the study, an ECG is performed.
In addition to diagnostic manipulations, on the eve of laparoscopy of the ovaries, the intestines should be cleaned. For this purpose, laxatives or enemas are used. Considering that the operation is performed under general anesthesia, food and water should not be taken a few hours before it. Please note that the procedure is not performed during menstruation due to the high risk of blood loss.
Stages of laparoscopy for polycystic ovaries
Like any operation, laparoscopy for polycystic ovaries is performed in stages. First of all, you should know that this procedure is carried out using an optical device,video cameras and special tools. All of these items are very small. The operation includes the following steps:
- Administration of general anesthesia (intravenous anesthesia).
- Performing 3 or 4 incisions on the surface of the anterior abdominal wall. The diameter of each of them does not exceed 1 cm. In the lower abdomen, 2 incisions are made for the introduction of surgical instruments, in the navel area - for an optical device and a camera.
- Injection of carbon dioxide into the abdominal cavity to improve visualization of organs.
- Isolation of the ovaries.
- Removal of cysts. This step can be done in different ways.
- Coagulation of damaged vessels. Before leaving the abdominal cavity, the doctor must ensure that there is no bleeding.
- Removal of instruments from the patient's body.
- Suturing the incisions.
The technique for removing cysts depends on which laparoscopy option was planned. On average, the operation lasts from 30 to 60 minutes.
Polycystic Ovarian Laparoscopy Recovery
Given that laparoscopy is a minimally invasive procedure, complications after this operation are rare. Nevertheless, it is necessary to allow the woman's body to recover. For this, patients stay in the hospital for 7-10 days after surgery. During this period of time, the pain syndrome is stopped (if it took place), the work of the intestines is getting better. On the first day, the patient is recommended to get up on her feet, if possible, to walk around the ward. itnecessary to avoid the development of adhesions in the pelvis. 6 hours after laparoscopy, a woman is allowed to drink (water, broths). You can eat the next day. Physical activity and sexual intimacy should be postponed for 1 month. The sutures are removed 10 days after the operation.
Ovarian laparoscopy and pregnancy
Many women are interested in the question: is laparoscopy compatible with polycystic ovaries and pregnancy? Naturally, the answer is yes. Indeed, in most cases, this operation is performed to treat infertility. Therefore, in the presence of polycystic disease and planning pregnancy, laparoscopy is necessary. However, after the operation, you can not immediately begin to conceive.
Features of laparoscopy in pregnant women with polycystic ovaries
In some cases, women can conceive a child despite PCOS. This happens if the disease has developed recently or the liquid formations are small. In cases where the pathology is detected during pregnancy, surgical treatment is contraindicated. In this case, strict supervision by a gynecologist is necessary.
Planning pregnancy after laparoscopy
How to plan a pregnancy after laparoscopy of the ovaries with polycystic? If this disease was the cause of infertility, then conception becomes possible due to the operation. However, 3 months after laparoscopy, a woman must take hormonal drugs. After this time, a number of studies are carried out. After that, you can begin to conceive a child.
Laparoscopy for polycystic ovaries and pregnancy: doctors' reviews
In most cases, doctors recommend minimally invasive surgery, as they reduce the risk of complications and are considered less traumatic. Often, a desired pregnancy occurs after laparoscopy of the ovaries with polycystic disease. Reviews of gynecologists confirm this information. Nevertheless, doctors argue that the first stage of treatment should be drug therapy. The operation is recommended when conservative methods are ineffective.
Laparoscopy for polycystic ovaries: patient reviews
Women who underwent surgery were satisfied with the result. They claim that this intervention helped to cope with such a pathology as polycystic ovaries. After laparoscopy, the feedback from most patients was positive. Some women were able to have children thanks to the operation. Also, patients note that menstruation after laparoscopy of the ovaries became regular. In addition to the normalization of the cycle, women indicate a change in the nature of the discharge, a decrease in pain before menstruation.
