Ovarian surgery to cure PCOS

Ovarian Surgery: The Cure to PCOS

The latest ovarian surgery used to treat PCOS symptoms is laparoscopic ovarian drilling where electrocautery or laser is employed to destroy parts of the ovary. Regular ovulation can be triggered by destroying certain areas of the ovary that produce excess androgens. Women who have not responded to medication and other methods of PCOS treatment in Chennai may resume regular menstrual cycles in the months following surgery and even achieve pregnancy. Ovarian Surgery for PCOS is only recommended after treatments such as weight loss and fertility medicines have had no effect or not tolerated. The procedure of ovarian surgery is chosen to restore menstrual cycle only in women with severe symptoms of PCOS and help them ovulate. Women with no other fertility glitches that can stop pregnancy, such as blocked tubes or male infertility usually get pregnant after ovarian surgery.

The procedure for Ovarian surgery in PCOS

Over the years, many surgical approaches for restoring ovulation in women with PCOS have been studied. Classical wedge resection, multiple ovarian biopsies, laser vaporization and electrocautery are some of the examples. Ovarian surgeries of all types can be seen as equivalent procedures because they share a common goal of creating ovarian damage. All methods of ovarian drilling to induce ovulation attempt to use the lowest possible dose to achieve the desired effect. Two types of ovarian surgery have been in use in the treatment of PCOS:

Ovarian block resection 

Surgical removal of part of the ovary, was practised to bring back regular menstrual cycle and promote normal ovulation. But in the recent times, most of the doctors rarely use this method of ovarian surgery as they strongly acclaim high risk of scarring on the ovary from resection. Patients need to be cautious and seek a second opinion if this process of ovarian surgery is suggested for PCOS treatment.

Laparoscopic ovarian surgery – A minor surgical procedure called laparoscopic ovarian drilling (LOD) where electrocautery or laser is accustomed to abolish certain parts of the ovary. LOD is generally performed through a small incision made in the abdomen, the patient being under general anaesthesia. . Then a tube is placed through the incision to inflate the belly with a small amount of air, allowing the surgeon to safely pass the viewing tool, which is a long, thin microscope called laparoscope, without causing damage to the pelvic organs. A tiny camera is fixed to the tool that helps see the ovaries. With a view of the internal organs through the laparoscope, through the same incision or other small incisions in the pelvic area, surgical tools may be inserted. Then, using heat or laser that can destroy the tissues that produce androgens, the ovaries will be surgically treated. LOD has been found to lower levels of testosterone and luteinising hormone (LH), and raise levels of follicle-stimulating hormone (FSH). Thus, hormone imbalance can be restored for normal function of ovaries. This procedure can help trigger ovulation as treatment for fertility problems associated with PCOS in Chennai, that do not respond to medicine, at the same time avoiding the risk of scarring on the ovaries.

When to get ovarian surgery for PCOS?

Polycystic ovary syndrome (PCOS) is a complicated hormonal disorder of different body systems not only affecting menstrual cycle and fertility, but also increasing risk of heart disease and diabetes after menopause. Thus, PCOS is a lifetime problem to which there is no permanent solution. Ovarian surgery cannot cure PCOS, rather eliminate the symptoms of PCOS by subjecting the ovaries to surgery as they are responsible for the increased level of androgen production in PCOS. Ovarian surgery might reduce the levels of androgen production which in return can result in curing some of the PCOS symptoms. PCOS does not involve just the ovarian dysfunction but disturbs other organs and hormonal systems as well. Ovarian surgery can help reduce symptoms of PCOS depending on the level of severity of symptoms and extensity of organs and hormones affected by the symptoms. Ovarian surgery in PCOS may be considered as a one-time treatment contrasting to the fertility medicines that have to be taken regularly. Ovarian surgery might benefit some women in treating the problem for a period of time in certain cases, but this surgical treatment does not offer a permanent cure. Whereas other women with PCOS will not find relief from irregular menstrual cycle and anovulation, even temporarily but ovarian surgery may help these women with PCOS to respond better to fertility medicines. Hence, if ovarian surgery to correct PCOS symptoms is opted, all of the non-surgical treatments have to be evaluated before going for the procedure. 

Benefits of Ovarian surgery in PCOS

  • Laparoscopic ovarian drilling is a simple procedure performed by minimal access that can be done on an outpatient basis. 
  • It provides an alternative treatment option in PCOS where anovulation persists as no response to medicines and lifestyle management. 
  • The beneficial effect of LOD is due to destruction of the androgen-producing stroma in the ovaries. 
  • The majority (56-94%) of PCOS patients who are resistant to medications ovulate after drilling, and at least half of them go on to achieve pregnancy. 
  • Predictive factors for pregnancy through ovarian drilling are younger age and lower body mass index. 
  • The hormonal changes resulting from ovarian drilling last for an extended period of time. 
  • Combination of exogenous gonadotrophin treatment and laparoscopic ovarian drilling yield high rates of ovulation and pregnancy. 
  • Risk of multiple pregnancy is rare with ovarian drilling. 

Risks associated with ovarian surgery are like any other surgeries associated with anaesthesia. Besides that, lower abdominal pain, bleeding, damage or scarring of the reproductive organs and infection that is possible following a careless procedure can occur. To minimize such risks, it is important to select the best specialist with many years of experience in performing LOD for Polycystic Ovarian Syndrome treatment in Chennai. Having a detailed discussion with the specialist, about why ovarian surgery would be appropriate and knowing their experience in PCOS treatment using ovarian drilling can give better clarity.

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