Ovarian function following use of various hemostatic techniques during treatment for unilateral endometrioma: A randomized controlled trial

Objective To compare the effect of hemostatic techniques (bipolar energy versus hemostatic sealants versus suture) on the ovarian reserve of patients submitted to laparoscopic cystectomy for the surgical excision of unilateral endometrioma. Methods A randomized controlled trial conducted in a teaching hospital included 84 patients with unilateral endometrioma. The patients underwent laparoscopic stripping for excision of the unilateral endometrioma between March 2018 and February 2020. Three different hemostatic techniques-bipolar energy (Group 1), hemostatic sealants (Group 2), and suture (Group 3)-were compared. Anti-Mullerian hormone (AMH) levels were measured before, and 1 and 6 months after surgery to determine changes in ovarian function. Results Following surgery, AMH levels decreased in all the groups; however, this decrease was not statistically significant. Comparison between groups showed no statistically significant differences in AMH levels between the three hemostatic techniques used. Six months after surgery, median AMH levels were: 1.65 ng/mL (interquartile range [IQR] 0.62-2.08 ng/mL) in Group 1, 1.87 ng/mL (IQR 1.27-2.97 ng/mL) in Group 2, and 1.53 ng/mL (IQR 1.18-2.44 ng/mL) in Group 3. Conclusion The present study suggests that there is no difference between the different hemostatic techniques used in laparoscopic cystectomy for the treatment of unilateral endometriomas. Registered at ClinicalTrials.gov: NCT03430609.