Drill Doctor
 |
| No items matching your keywords were found. |
Drill Doctor
Ovarian Drilling
Ovarian Drilling
By Prof Ghulam Mohy-ud-din Wani ARS Bvsc &AH,MVSc,PhD,DVM Germany,(GOLDMEDALIST)
Ovarian drilliing
Ovarian drilling is name given to the techniques which punctures the ovary with a needle .It reduces the male hormone within few days.This technique is known to veterinarians since long.We used to perform per rectal palpation of the ovaries and attemped to rupture the follicular cysts.Many attempts to cure poly cystic ovaries in animalsusing these techniques has been reported. LAPAROSCOPIC OVARIAN DRILLING Here using laparoscopy a laser fibre or electrosurgical needle punctures the ovary 4 to 10 times. This treatment results in a dramatic lowering of male hormones within days and is often performed in women who have polycystic ovary syndrome (PCOS).
Studies have shown that up to 80 percent of patients will benefit from such treatment. Many women who fail to ovulate with clomiphene or Metformin therapy will respond when these medications are reintroduced to the system after ovarian drilling. Side effects are rare, but may result in adhesion formation or ovarian failure if there are complications during the procedure Laparoscopic Ovarian Diathermy or Ovarian Drilling Women with PCOS ovulate after ovarian drilling or wedge resection. After surgery, ovulation occurs spontaneously in 70-90% of women and the probability of pregnancy after one year reported in 40-60%. If ovulatory cycles fail to restore after the surgery, the doctor may restart ovulation induction. A recent study up to 20 years after laparoscopic drilling has shown persistence of ovulation over many years. Compared with medical treatment, it need only be performed once and intensive monitoring is not required. The main problems associated with surgery include adhesion formation, the risk of destruction of the ovaries leading to ovarian failure. In addition, there are risks associated with surgery and anaesthesia. Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women with polycystic ovary syndrome (PCOS) who have not responded to weight loss and fertility medication. Electrocautery or laser is used to destroy portions of the ovaries. Laparoscopy is usually done with general anaesthesia. A small incision is made in the abdomen at the navel. A tube is used to inflate the abdomen with a small amount of carbon dioxide gas so the laparoscope can be inserted without damage to the abdominal internal organs. The surgeon looks through the laparoscope at the internal organs. Surgical instruments may be inserted through the same incision or other small incisions in the pelvic area. This shows how the drilling is actually performed What To Expect After Surgery If you have a laparoscopy procedure, you can usually go home the same day and resume normal activities within 24 hours. Your return to normal activities will also depend on how quickly you recover from surgery, which may take a few days or as long as 2 to 4 weeks. Why It Is Done Ovarian drilling is done for women with PCOS who have not responded to weight loss and fertility medication. Partial ovarian destruction has been reported to restore regular ovulation cycles. How Well It Works Case series studies of women with PCOS have reported that ovarian drilling results in an 80% ovulation rate and a 50% pregnancy rate. The advantage of laparoscopy is that tubal patency can be checked at the same time in a single procedure, and ovarian drilling of either one or both ovaries appears to restore ovulation in a substantial number of patients. Serum concentrations of LH and testosterone decrease rapidly after ovarian drilling with a sustained mid- and long-term effect. The proportion of women with regular menstrual cycles increases substantially after drilling and is sustained at long-term follow-up. Ovulation and pregnancy rates are substantially increased in the period after the operation and appear to be maintained. Resistance to the effects of ovarian drilling include marked obesity, very elevated l evels of androgens, and long duration of infertility. Addition of other ovulating agents such as clomiphene citrate or FSH appears to improve the effectiveness of laparoscopic ovarian drilling Summary of Ovarian Drilling: Indications • PCO patient undergoing a diagnostic laparoscopy for tubal patency [tube testing] • Clomiphene resistant patients • Poor response to any ovulation inducing drugs Techniques • Laser • Cautery • Multiple punch biopsies Clinical advantages • Improved endocrine profiles • Spontaneous ovulation • Reduction in gonadotropin doses for ovulation induction and hence reduction in cost of further stimulated cycles • Improvement in pregnancy rates • Reduction in multiple pregnancy rates • Reduction in first trimester abortions • Reduction in ovarian hyperstimulation Clinical disadvantages • Possibility of adhesion formation [reduced with instillation of plenty of fluids after the procedure] • Possible compromise to ovarian function and menopause at an earlier age but this is not confirmed • Surgical and anaesthesia risk as with any surgical procedure Laparoscopic ovarian drilling (ovarian diathermy) for PCOS Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women with polycystic ovary syndrome (PCOS). Electrocautery or a laser is used to destroy parts of the ovaries. This surgery is not commonly used. But it can be an option for women who are still not ovulating after losing weight and trying fertility medicines. Ovarian drilling is usually done through a small incision (laparoscopy), with general anesthesia. The surgeon makes a small cut (incision) in the abdomen at the belly button. The surgeon then places a tube to inflate the abdomen with a small amount of carbon dioxide gas so that he or she can insert the viewing instrument (laparoscope) without damage to the internal organs. The surgeon looks through the laparoscope at the internal organs. Surgical instruments may be inserted through the same incision or other small incisions in the pelvic area. Because the incisions are so small, laparoscopy is often called "Band-Aid surgery." What To Expect After Surgery If you have a laparoscopy procedure, you will likely go home the same day and can do your normal activities within 24 hours. Your return to normal activities will depend on how quickly you recover from surgery, which may take a few days or as long as 2 to 4 weeks. Why It Is Done Ovarian drilling is sometimes used for women with PCOS who are still not ovulating after trying weight loss and fertility medicine. Destroying part of the ovaries has been reported to restore regular ovulation cycles.1 How Well It Works Studies of women with PCOS have shown that ovarian drilling results in an 80% ovulation rate and a 50% pregnancy rate.1 Younger women and those with a body mass index in the normal range are most likely to benefit from laparoscopic ovarian drilling.2 Risks Risks of laparoscopy include: • Infection of the incision. • Bleeding from the incision. • Internal bleeding. • Accidental injury to internal organs or major blood vessels, from the laparoscope or surgical instruments.
About the Author
prof Ghulam MOHYUDDIN WANI WRITES THIS TIME FOR MANY PATIENS SUFFERING FROM ovarian cysts.He wishes his students to use this as their future research topic/Thanks
Product Spotlight: Drill Doctor DD350X Bit Sharpener