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ovarian wedge resection
This surgical procedure was developed for the treatment of polycystic ovarian syndrome (PCOS) based on a simple premise: if the ovary is producing too much of a hormone (androgens in PCOS), then removing part of the ovarian tissue should decrease the amount of the hormone produced. Although this premise isn’t completely accurate, the procedure has been successful and remains a viable option. The procedure was introduced by Stein and Leventhal, the same two healthcare providers who identified PCOS.
Wedge resection isn’t done as frequently since it leaves many women with little ovarian tissue which results in a poor response to gonadotropins. Ovarian drilling is the current surgical treatment of choice. It can be done laparoscopically by making small holes in the ovarian coating or capsule with a laser or cautery needle. This procedure yields the same positive effects as wedge resection while preserving much more of the ovarian tissue.
Prior to the use of ovarian drilling, wedge resection was done on women who were resistant to clomiphene therapy.
how it works
Removing a section of the tissue that secretes the hormone produces a sustained reduction in androgen and estrogen levels, which is believed to prevent the release of eggs from the ovary. The loss of tissue also lowers the amount of inhibin that is flowing through the body.
Post-operative increases in follicle-stimulating hormone (FSH) levels and in the emergence of a dominant follicle signify that the surgery was a success. The procedure can now be done by cautery, diathermy or laser vaporization with a laparoscope, and can be performed in conjunction with a diagnostic laparoscopy.
In some women ovulation resumes permanently, while others ovulate intermittently and then return to a state of anovulation. Some don’t respond at all.
side effects
There are risks and side effects associated with ovarian wedge resection. Your healthcare provider will discuss important safety information with you about this procedure.
results
While ovarian wedge resection can be successful it is a surgical procedure. Other treatments such as lifestyle management and drug therapy should be considered.
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