Laparoscopy for polycystic ovary: preparation, administration and postoperative period

Gynecological diseases are found in almost every second woman. Among them, polycystic ovaries are quite common. This pathology does not apply to infectious diseases. Therefore, it is impossible to catch it. In addition, such an ailment is found only among women. In some cases, pathology is formed as early as adolescence. Sometimes the disease is congenital. One of the methods of treatment is laparoscopy for polycystic ovaries. Feedback about this procedure are various. After all, it refers to one of the types of surgical interventions. Therefore, some women prefer to use other methods of treatment. Nevertheless, according to doctors, sometimes this operation is necessary.

What is polycystic ovary?

Polycystic ovary refers to hormonal pathologies. The disease can be congenital and acquired throughout life (often in adulthood). In the first case, it is genetically conditioned, that is, it is formed in the embryonic period. Nevertheless, congenital polycystosis is diagnosed only in adolescence. Until this time, pathology has not been manifested. Acquired polycystic ovary often develops against the background of endocrine disorders. These include diabetes, obesity, adrenal and thyroid gland diseases. Sometimes polycystosis is formed after brain injuries, prolonged intake of hormonal drugs. The mechanism of development of this pathology consists in the following changes:

1. Decreased production of estrogen and progesterone. Increase in the level of male sex hormones - androgens.
2. Thickening of the ovary. As a result, the follicles do not collapse, and the egg does not come out. In violation of ovulation infertility is developing.
3. Filling of the follicles with liquid and the formation of cysts.

Similar changes occur if pathology is acquired. In this case, the disease is called polycystic ovary syndrome (PCOS). His symptoms include: weight gain, hypertrichosis, infertility. Symptoms of congenital pathology include underdevelopment of the "female form" (narrow pelvis, poorly formed mammary glands), acne, oligomenorrhea.

Conducting laparoscopy in polycystosis

Laparoscopy for polycystic ovary 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 with open surgery, laparoscopy is less traumatic. Other advantages include:

1. Reducing the risk of complications.
2. Shortening of the postoperative period.
3. Quick recovery.
4. Minimal aesthetic defects (in comparison with open surgery on the abdominal cavity).

Despite the obvious advantages of the method, there are still disputes: is it worth doing laparoscopy for polycystic ovaries? After all, some doctors advise women to begin to try drug therapy. In fact, in some cases, conservative treatment helps to cope with polycystosis. In order to restore the functions of the ovaries, women with sex hormones are treated. Also, medications blocking the synthesis of androgens are prescribed. Nevertheless, the drugs are not always effective. Especially in the case of acquired disease. Therefore, if the effect is not observed after the course of drug treatment, laparoscopy is recommended for polycystic ovaries. By this method is meant the removal of fluid formations from the cavity of the organ with the help of special surgical equipment. The incisions at 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 depends on the goal that the surgeon pursues, as well as the technical capabilities of the medical institution. Like all such surgical interventions, ovarian laparoscopy can be diagnostic and therapeutic. The first is carried out with a suspicion of polycystosis, when pathology has not yet been identified with precision. Often diagnostic laparoscopy turns into therapeutic manipulation. The second, in turn, is divided into several options. Among them:

1. Decortisation of the ovaries. This type of therapeutic laparoscopy is to remove the upper shell of the organ. Due to decortization, the surface layer is thinned, allowing ripening and rupture of the follicles.
2. Cauterization of cysts. A similar method of treatment is performed using laser equipment. The operation consists in performing 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.
3. Resection of the ovary. It is characterized by the removal of part of the organ, in which the cysts are located. This method can not be used if the fluid formations are located over the entire surface of the ovary.
4. Electrothercoagulation. This version of therapeutic laparoscopy is the performance of puncture of the organ in the places of cystic formations. Simultaneously, coagulation of the ovary is performed to avoid the development of bleeding.
5. Electrodrilling. It is the effect of the current on the region of the cysts. The contents of the formations are deleted.

All these variants of laparoscopy are considered effective. The difference between them is that not every procedure is performed in a specific clinic. Some of the treatments are considered expensive and are conducted only in specialized medical organizations.

Preparation for surgical intervention

Laparoscopy does not require complicated preparation. Nevertheless, compliance with certain rules before the operation is necessary. First of all, a few days before laparoscopy, a number of diagnostic studies are performed. They include: UAC, blood test for HIV infection, syphilis and hepatitis. Urine is also being studied to exclude kidney disease. In addition, important laboratory diagnostic procedures are: a biochemical blood test and a coagulogram. One day before the test, the ECG is performed.

In addition to diagnostic manipulations, on the eve of laparoscopy of the ovaries, the intestine should be cleared. For this purpose, laxative medicines or enemas are used. Given that the operation is carried out under general anesthesia, you can not eat food and water a few hours before it. It should be borne in mind that the procedure is not performed during menstruation because of the high risk of hemorrhage.

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, a video camera and special tools. All these items are very small. The operation includes the following steps:

1. Conduction of general anesthesia (intravenous anesthesia).
2. Performing 3 or 4 incisions on the surface of the anterior abdominal wall. The diameter of each of them does not exceed 1 cm. Two incisions are made at the bottom of the abdomen for the introduction of surgical instruments, in the navel - for the optical device and the camera.
3. Injection into the abdominal cavity of carbon dioxide in order to improve the visualization of organs.
4. Allocation of ovaries.
5. Removal of cysts. This stage can be conducted in different ways.
6. Coagulation of damaged vessels. Before leaving the abdominal cavity, the doctor must ensure that there is no bleeding.
7. Removal of instruments from the patient's body.
8. Sewing cuts.

The technique of removing cysts depends on which version of the laparoscopy was planned. On average, the operation lasts from 30 to 60 minutes.

Recovery after laparoscopy of the ovaries in polycystosis

Given that laparoscopy refers to minimally invasive procedures, complications after this operation rarely develop. Nevertheless, it is necessary to give the woman the body to recover. For this, the patients stay in the hospital 7-10 days after the operation. For this period of time the pain syndrome is stopped (if it took place), the intestinal work is being adjusted. In the first day of the patient is recommended to get up on his feet, if possible - walk in the ward. This is necessary to avoid the development of adhesive process in the small pelvis. 6 hours after laparoscopy, a woman is allowed to drink (water, broth). You can eat already the next day. Physical activity and sexual intimacy should be postponed for 1 month. Sutures are removed 10 days after the operation.

Laparoscopy of ovaries and pregnancy

Many women are interested in the question: is laparoscopy compatible with polycystic ovaries and pregnancy? Naturally, the answer is yes. After all, in most cases, this operation is carried out for the purpose of treating infertility. Therefore, in the presence of polycystosis and pregnancy planning laparoscopy is necessary. However, after the operation, you can not immediately begin to conceive.

Features of laparoscopy in pregnant women with polycystic ovary

In some cases, women can conceive a child, despite the polycystic ovaries. This occurs if the disease has developed recently or fluid formations have small dimensions. In cases where pathology is detected during pregnancy, surgical treatment is contraindicated. At the same time, strict supervision at the gynecologist is necessary.

Pregnancy planning after laparoscopy

How to plan pregnancy after laparoscopy of ovaries in case of polycystosis? If the cause of infertility was precisely this disease, then conception becomes possible due to the operation performed. However, 3 months after laparoscopy, a woman should take hormonal drugs. After this time, a number of studies are carried out. Then you can begin to conceive a child.

Laparoscopy for polycystic ovary and pregnancy: reviews of doctors

In most cases, doctors recommend minimally invasive surgery, as they reduce the risk of complications and are considered less traumatic. Often comes the coveted pregnancy after laparoscopy of the ovaries in polycystosis. Reviews of gynecologists confirm this information. Nevertheless, doctors say that the first stage of treatment should be drug therapy. The operation is recommended when conservative methods are ineffective.

Laparoscopy for polycystic ovary: reviews of patients

Women who underwent surgery were satisfied with the result. They argue that this intervention helped to cope with a pathology such as polycystic ovary. After laparoscopy, the reviews of most patients were positive. Some women could have children, thanks to surgery. Also, the patients note that the monthly after the 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 reduction in the pain syndrome before menstruation.