Endometrioma Clinical Trial
In this study, impacts of hemostatic matrix and bipolar electrocoagulation on ovarian reserve in women undergoing ovarian endometrioma excision are compared.
Endometriosis is defined as the existence of endometrial tissue outside of the uterine
cavity. Ovaries are the most common effected sites and the disease causes endometriotic
cysts in the ovaries. The treatment of endometriomas is still highly controversial. It is
well known that the ovarian reserve is compromised as a result of endometriomas. Even though
a variety of medical agents can be used to treat endometriomas, when endometriomas cause
pelvic pain or infertility especially when they are > 4cm in size, surgical treatment can be
offered. Even though there is no standard surgical treatment removal of cyst wall is usually
the preferred method. Aspiration of cyst fluid and coagulation of the cyst wall have been
practiced, however are associated with more recurrences.
Nevertheless, the impact of surgical treatment on ovarian reserve has not been clarified.
There are mainly two types of ovarian injury during surgical removal of endometriomas.
First, there is risk that the healthy ovarian tissue can be removed along with the cyst
wall. Second, there is risk of of thermal injury that occurs after cyst removal during
hemostasis by electrocoagulation.
By this context, investigating an alternative method to electrocautery which causes less
thermal injury to ovary would open a new strategy in the treatment of infertile patients
with endometrioma.
A new method "hemostatic matrix" has been developed to provide hemostasis. Endometriomas can
be treated without thermal injury to healthy ovarian tissue using this method compared to
bipolar coagulation.
In the literature, there is no controlled randomized study compared hemostatic matrix and
bipolar coagulation for impact on ovarian reserve after treatment ovarian endometriomas.
There are two main principles when treating endometriomas. First, recurrence should not
occur, and the second is minimal ovarian injury.
On the backgrounds of this philosophy, it can be hypothesized that hemostatic matrix can
cause less damage to ovarian tissue compared to classical bipolar coagulation.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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