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How to do Laparoscopic Ovarian Drilling?

 

Polycystic ovary syndrome is a symptom in which it comes with an imbalance of a woman's female sex hormones. This hormone imbalance could cause alterations in the menstrual period, skin changes, small cysts in the ovaries, trouble getting pregnant, and other problems.

Causes, Incidence, and Risk of PCOS

Female sex hormones include estrogen and progesterone, in addition to hormones called androgens. Androgens, often called "male hormones," are also contained in women, however in different amounts.

Female hormones help regulate the standard development of eggs in the ovaries during each menstrual period. PCOS is related to an imbalance in these female sex hormones. An excessive amount of androgen hormone is made, together with changes in other hormonal levels. It is not completely understood why or how the alterations in the hormone levels occur.

In female ovary follicles are sacs within the ovaries that contain eggs. Normally, a number of eggs are released during each menstrual period. This is called ovulation. In pcos, the eggs during these follicles don't mature and therefore are not released in the ovaries. Instead, they are able to form really small cysts within the ovary. These changes can contribute to infertility. Another the signs of this issue are due to the hormone imbalances.

Women are often diagnosed much more their 20s or 30s, but PCOS could also affect teenage girls. The symptoms often begin whenever a girl's periods start. Women with this particular disorder usually have a mother or sister that has symptoms similar to those of pcos.
Symptoms

Changes in the females menstrual cycle due to PCOS:

Absent periods, usually having a good reputation for having a number of normal menstrual periods during puberty called secondary amenorrhea, Irregular menstrual periods, which can be pretty much frequent, and may vary from very light to very heavy.

  1. Development of male sex characteristics (virilization):
  2. Decreased breast size
  3. Deepening from the voice
  4. Enlargement from the clitoris
  5. Increased body hair around the chest, abdomen, and face, as well as round the nipples (called hirsutism)
  6. Thinning of the hair on the head, called male-pattern baldness

Other skin changes:

  1. Acne that worsens
  2. Dark or thick skin markings and creases around the armpits, groin, neck, and breasts because of insulin sensitivity
  3. Signs and tests

Throughout a pelvic examination, the health care provider may note an enlarged clitoris (very rare finding) and enlarged ovaries. Diabetes, high blood pressure, and cholesterol are common findings, as are weight gain and obesity. Weight, body mass index (BMI), and abdominal circumference are of help in determining risk factors.

Amounts of different hormones which may be tested in PCOS include:

  1. Estrogen levels
  2. FSH levels
  3. LH levels
  4. Testosterone levels
  5. 17-ketosteroids
  6. Fasting glucose and other tests for glucose intolerance and insulin resistance
  7. Lipid levels
  8. Serum HCG
  9. Prolactin levels
  10. Thyroid function tests
  11. Other tests may include:
  12. Vaginal ultrasound to check out the ovaries
  13. Pelvic laparoscopy to appear more closely at, and possibly biopsy the ovaries

Treatment of PCOS

Slimming down has been shown to help with diabetes, hypertension, and high cholesterol. A weight reduction of 5% of total bodyweight can help with the imbalance of hormones as well as with infertility. Medications used to treat the abnormal hormones and menstrual cycles of polycystic ovary syndrome include:

  1. Birth control pills or progesterone pills, to help make menstrual cycles more regular
  2. Metformin, a medication that increases the body's sensitivity to insulin, can improve the symptoms of PCOS and sometimes will cause the menstrual cycles to normalize. For some women, it can also assist with weight loss.
  3. LH-releasing hormone (LHRH) analogs
  4. Treatment with clomiphene citrate causes the egg to mature and be released. Sometimes women need this or any other fertility drugs to get pregnant.
  5. Medications or any other treating abnormal hair growth include:
  6. Birth control pills. It might take many months to begin noticing a difference.
  7. Anti-androgen medications, such as spironolactone and flutamide might be tried if birth control pills fail to work.
  8. Eflornithine cream may slow the growth of unwanted facial hair in females.

Some female may need hair removal using laser and nonlaser light sources damages individual hair follicles so they do not re-grow. This can be expensive and multiple remedies are needed. Sometime laser removal could be combined with other medicines and hormones.

Glucophage (Metformin), which is generally used in diabetes a medicine that makes cells more sensitive to insulin, might help make ovulation and menstrual cycles more regular, prevent diabetes type 2, and add to weight loss whenever a weight loss program is followed.

Pelvic laparoscopy to get rid of a piece from the ovary or drill holes within the ovaries may also be completed to treat the lack of ovulation (anovulation) and infertility. The results are temporary.
Expectations (prognosis)

Women who have this problem can get pregnant with the right surgical or medical treatments. Pregnancies are often normal.

Complications

Increased chance of endometrial cancer, Infertility early treatment of polycystic ovary disease might help prevent infertility or boost the chance of having a healthy pregnancy. Obesity-related BMI over 30 and waist circumferance more than 35 conditions, for example hypertension, heart disease, and diabetes. Possible increased chance of breast cancer.

Laparoscopic Ovarian Drilling

For female suffering from polycystic ovarian syndrome surgical treatment is recommended should the treatment fail and for women who have experienced many problems due to PCOS including infirtility. This can be done by laparoscopy either by laparoscopic ovarian drilling or ovarian wedge resection. It is not clear why women with PCOS ovulate after ovarian drilling or wedge resection. After surgery, ovulation occurs spontaneously in 70-90% of women and the possibility of pregnancy after twelve months is in the region of 40-60%. There is no increased chance of multiple pregnancy or OHSS. If ovulatory cycles neglect to restore after the laparoscopic surgery, a gynecologist may restart ovulation induction. A recent study as much as 20 years after laparoscopic drilling indicates persistence of ovulation over a long time. In contrast to treatment, it need only be performed once and intensive monitoring is not required. The primary problems related to surgery include adhesion formation, the risk of destruction from the ovaries resulting in ovarian failure. In addition, you will find risks associated with surgery and anaesthesia.

Laparoscopic ovarian drilling is really a surgical treatment that may trigger ovulation in females with polycystic ovary syndrome (PCOS) who have not responded to weight reduction and fertility medication. Electrocautery or laser can be used to eliminate servings of the ovaries.

Laparoscopy is usually completed with general anaesthesia. A little incision is created in the abdomen in the navel. A tube is used to inflate the abdomen with a little bit of co2 gas so the laparoscope can be inserted without harm to the abdominal organs. Choices looks through the laparoscope at the internal organs. Surgical instruments might be inserted using it . incision or any other small incisions within the pelvic area

 

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