Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Fertil Steril. 2010 Feb;93(3):969-75. doi: 10.1016/j.fertnstert.2008.10.046. Epub 2008 Dec 18.
To evaluate the size of ovarian damage caused by ovarian drilling in polycystic ovary syndrome, the amount of inflicted damage was assessed for the most frequently used ovarian drilling techniques.
Experimental prospective design.
University clinic.
PATIENT(S): Six fresh bovine ovaries per technique.
INTERVENTION(S): Carbon dioxide (CO(2)) laser, monopolar electrocoagulation, and bipolar electrocoagulation were used for in vitro ovarian drilling.
MAIN OUTCOME MEASURE(S): Amount of inflicted ovarian damage per procedure.
RESULT(S): Bipolar electrocoagulation resulted in significantly more destruction per burn than the CO(2) laser and monopolar electrocoagulation (287.6 versus 24.0 and 70.0 mm(3), respectively). The damage found per lesion was multiplied by the regularly applied number of punctures per procedure in daily practice (based on the literature). Again, the bipolar electrocoagulation resulted in significantly more tissue damage than the CO(2) laser and monopolar coagulation (2,876 versus 599 and 700 mm(3), respectively).
CONCLUSION(S): Ovarian drilling, especially bipolar electrocoagulation, causes extensive destruction of the ovary. Given the same clinical effectiveness of the various procedures, it is essential to use the lowest possible dose that works; thus, the first choice should be CO(2) laser or monopolar electrocoagulation.
评估卵巢打孔术在多囊卵巢综合征中引起的卵巢损伤程度，评估最常用的卵巢打孔技术造成的损伤程度。
实验前瞻性设计。
大学诊所。
每种技术 6 个新鲜牛卵巢。
二氧化碳（CO2）激光、单极电凝和双极电凝用于体外卵巢打孔。
每次手术造成的卵巢损伤量。
与 CO2 激光和单极电凝相比，双极电凝每次灼伤造成的破坏明显更多（分别为 287.6、24.0 和 70.0mm3）。根据文献，将每个病灶发现的损伤乘以日常实践中每例应用的常规穿刺数。同样，与 CO2 激光和单极电凝相比，双极电凝造成的组织损伤明显更多（分别为 2876、599 和 700mm3）。
卵巢打孔术，特别是双极电凝术，会导致卵巢广泛破坏。鉴于各种手术的临床效果相同，使用尽可能低的有效剂量至关重要；因此，首选应该是 CO2 激光或单极电凝。
