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2 results

  • 14 - Surgical management of anovulatory infertility in polycystic ovary syndrome

  • Edited by Adam Balen, University of Leeds, Stephen Franks, Roy Homburg, Sean Kehoe
  • Book:
    Current Management of Polycystic Ovary Syndrome
    Published online:
    05 July 2014
    Print publication:
    01 October 2010, pp 165-172

  • Summary

    The surgical management of anovulatory infertility in polycystic ovary syndrome (PCOS) has traditionally involved the use of clomifene citrate and then gonadotrophin therapy or laparoscopic ovarian surgery in those who are clomifene-resistant. Laparoscopic ovarian surgery is a useful therapy for anovulatory women with PCOS who need a laparoscopic assessment of their pelvis or who live too far away from the hospital to be able to attend for the intensive monitoring required for gonadotrophin therapy. Commonly employed methods for laparoscopic surgery include monopolar electrocautery (diathermy) and laser. The risk of periovarian adhesion formation can be reduced by abdominal lavage and early second-look laparoscopy, with adhesiolysis if necessary. The chance of achieving a continuing pregnancy within 6 months is less than with carefully conducted ovulation induction with gonadotrophins but, if adjuvant ovulation induction agents are used in those who do not initially respond, the 12-month pregnancy rates are similar.

  • Comparison of radiofrequency and monopolar electrocautery tonsillectomy

  • F Aksoy, O Ozturan, B Veyseller, Y S Yildirim, H Demirhan
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 2 / February 2010
    Published online by Cambridge University Press:
    30 November 2009, pp. 180-184
    Print publication:
    February 2010
  • Objectives:

    To compare the efficacy and safety of radiofrequency and monopolar electrocautery tonsillectomy, regarding operation duration and tonsillectomy morbidity, including post-operative pain and haemorrhage and tonsillar fossa healing, in patients with recurrent chronic tonsillitis.

    Study design:

    A prospective, randomised, double-blind, controlled clinical study.

    Methods:

    Fifty patients aged over 10 years who required tonsillectomy were randomly assigned to have one tonsil removed by radiofrequency and the other by monopolar electrocautery. Operation duration, post-operative haemorrhage, post-operative pain and tonsillar fossa wound healing were compared.

    Results:

    The mean ± standard deviation of the operation duration required for the radiofrequency method was significantly longer than that for monopolar electrocautery: 8.1 ± 1.6 minutes vs 7.3 ± 1.5 minutes, respectively (p = 0.034). Post-operative haemorrhage was observed in only three patients (13.6 per cent). Inter-group analysis showed no significant differences in post-operative pain scores for the radiofrequency vs monopolar electrocautery methods (3.7 ± 1.6 vs 3.3 ± 1.4, respectively; p < 0.126). Inter-group analysis showed that tonsillar fossa wound healing scores evaluated on the fifth, 10th and 14th post-operative days were significantly higher in the radiofrequency group compared with the monopolar electrocautery group (p < 0.001).

    Conclusion:

    The present study results indicated that monopolar electrocautery tonsillectomy was superior to radiofrequency tonsillectomy in terms of post-operative tonsillar fossa wound healing; however, both techniques were comparable in terms of post-operative pain.