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Patients with PCOD are sometimes treated with an alternative treatment option that makes use of laparoscopy. In operative laparoscopy, multiple holes are drilled through the thickened ovarian capsule using a laser or cautery. This procedure is known as ovarian drilling, LEOS (laparoscopic electrocauterisation of ovarian stroma), or laparoscopic ovarian cauterization.

When the abnormal ovarian tissue is destroyed, it helps restore the normal functioning of the ovary and helps induce ovulation. In the case of certain younger patients, who have PCOD (only those who have large ovaries, excessive follicles and increased ovarian stroma), if the patient doesn’t get pregnant within 4 months, even after clomiphene treatment, we recommend that they consider laparoscopic surgery as the next treatment option.

This is typically because laparoscopic electrocauterisation of ovarian stroma helps us effectively correct the root cause of the problem. Of the patients who undergo this surgery, around 80% will have their regular cycles; of these, 50% will also end up conceiving within a period of one year; this would happen without them having to undergo any additional treatment or medication.

Laparoscopic Ovarian Cauterisation - The Risks

These patients find it very reassuring that they can have regular cycles without having to take any medications every months. One risk of this particular surgery is that if it isn’t performed by a competent doctor, it can induce adhesion formation. The other risk is that if it is conducted for patients who don’t have large ovaries, the ovarian tissue that gets destroyed can end up causing infertility. This happens because destruction of the ovarian tissue reduces ovarian reserve.

Newer treatment options available

In the past, doctors used to perform wedge resection which is also an ovarian surgery; this was done to help PCOD patients to ovulate. In this surgery, the abnormal ovarian tissue is removed; this essentially breaks PCOD’s vicious circle and helps in ovulation. Though wedge resection was once a popular treatment option, the adhesions that can occur around the ovary while the surgery is taking place, has now led to it being used more as a last resort. What is heartening is the fact that today, there are a number of treatment options available and it is possible to successful treat a large percentage of patients who have PCOD.

Summary

Patients with PCOD are sometimes treated with an alternative treatment option that makes use of laparoscopy. In operative laparoscopy, multiple holes are drilled through the thickened ovarian capsule using a laser or cautery. This procedure is known as ovarian drilling, LEOS (laparoscopic electrocauterisation of ovarian stroma), or laparoscopic ovarian cauterization.

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