is pcos surgery safe?

Answer 1

Surgery for PCOS isn't necessary (unless there is something else going on). What kind of surgery are you talking about? One of the more common ones is ovarian drilling. I would think about this before doing it. Talk to your doctors about all the risks. I would suggest learning about PCOS and the correct treatments before undergoing the knife. It is treatable without that. Here's some basic PCOS info:


It is important to really understand what PCOS is and the correct way to treat it. Unfortunatly, many doctors are not very knowledgeable and do not really understand much about PCOS. I recommend seeing a reproductive endocrinologist (RE). They are your best bet at correct PCOS treatment and any fertility treatments you may need. Here's a little general PCOS info to get you started:

The underlying cause of PCOS is insulin resistance (IR). The best treatment for PCOS is going on an insulin sensitizing drug such as metformin (1500-2550mg per day) combined with a low carb diet and exercise. There are a few important things to know:

1. Many women "pass" the test for IR, but still respond positively from the metformin. No one knows exactlly why..my thought is that the test is not a sure fire way of detecting the IR.

2. You must be on a high enough dose of metformin. I've heard women complain that their bodies dont start working even though they've been on metformin for awhile. Some doctors are hesitant to up the dose past 1500mg...but for some of us it takes more. I don't respond until my dose is around 2000mg a day.

3. It can take a few months on the correct dose, before your body is regulated. Hopefully you will start ovulating on your own and you will be able to get pregnant without any other treatment needed. If not, the RE can begin other fertility treatments while you are still on metformin.

4. It is important to treat your PCOS even if you are not trying to get pregnant. There are higher risks for many things (high blood pressure, blood clots, diabetes, and many other things) when you have PCOS, but if it is treated properly, then those risks are lowered.


I highly recommend visiting http://messageboards.ivillage.com/iv-bhp... It is a great message board where you can ask all your PCOS questions, including those about getting pregnant. Good luck.

Answer 2

With a competent surgeon experienced in this procedure, it's comparatively safe. Of course, all surgery does have risks and benefits. There are risks from things like bleeding, infection and anesthesia complications in any surgery.

Questions you should ask before this or any operation are :
What are the risks? What are the benefits?
Are there other types of surgery or nonsurgical options I could try?
How many times have you done this kind of surgery?
How long is recovery and what limitations will I have?
What is the likelihood of siccess and will I need repeated surgeries later?
And finally, what will happen if I choose not to have surgery?

A second opinion from another surgeon is an excellent idea, and most insurance even will encourage you to seek one.

Answer 3

Why would you have surgery for polycysitc ovarian syndrome? It is usually treated with hormones; oral contraceptives if you're not trying to get pregnant, or Clomid if you are trying to conceive. What kind of surgery are you talking about?

Answer 4

PCOS

Polycystic Ovarian Syndrome

The condition, polycystic ovarian syndrome, known as PCOS, is the commonest cause of ovulation disorders in women of reproductive age and is a familial condition. Polycystic ovarian syndrome (PCOS), is a primary ovarian condition and is characterized by the presence of many minute cysts in the ovaries and excess production of androgens. Polycystic ovarian syndrome can be found in apparently normal women and the full expression of the disease so-called “Stein-leventhal syndrome" is very uncommon. Polycystic ovarian syndrome is frequently associated with weight gain, excessive hair growth in the face and body, irregular and infrequent periods or absent periods, infrequent or absent ovulation, miscarriage and infertility. The cause of PCOS is not fully understood. There are long-term risks of developing type 2 diabetes, cardiovascular disease and cancer of the womb. Women diagnosed as having PCOS before pregnancy have an increased risk of developing gestational diabetes.

Incidence of Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) accounts for 90% of women with oligomenorrhoea (infrequent periods) and 30% of women with amenorrhoea (absent of periods) and over 70% of women with anovulation.

Diagnosis of Polycystic Ovarian Syndrome

Laparoscopy

Laparoscopy allows direct inspection of the ovaries; the ovaries are enlarged and polycystic. However, polycystic ovaries may appear normal at laparoscopy.

Vaginal ultrasound scan (better than abdominal)

The vaginal ultrasound may show the typical PCOS appearance but reliability varies with expertise.



Blood hormone levels of LH, FSH, androgens and SHBG

Ideally, these tests should be performed during the first four days of the cycle. If the women has no period, then the test can be performed anytime, and repeated if the results do not provide a clear picture.

FSH levels are low or normal, LH levels are often raised. However, a normal level does not exclude diagnosis of polycystic ovarian syndrome (PCOS). The levels of androgens and testosterone may be raised.

The American Society of Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology (ESHRE) joint consensus meeting in November 2003 agreed that the diagnosis of PCOS should be made when two of the following three criteria are met:

Infrequent or absent ovulation

Hyperandrogenism (clinical or biochemical) such as excess hair growth, acne, raised LH, and raised androgen index
Polycystic ovarian morphology on ultrasound scan (>12 follicles measuring between 2 and 9mm in diameter) and/or ovarian volume >10ml. The distribution of the follicles are not required and with one ovary sufficient for diagnosis.
Treatment of Polycystic Ovarian Syndrome in women who wish to conceive

Weight loss if she is over weight

This simple measure may restore menstruation and ovulation in patients with polycystic ovarian syndrome. Exercise and weight control also reduce the likelihood of developing type 2 diabetes in later life.

Ovulation induction with clomiphene (clomid) tablets

Induction of ovulation with clomiphene tablets is the first choice and is an effective treatment of polycystic ovarian syndrome (PCOS). It results in restoring menstruation and ovulation in about 70% of women and some 30% will conceive within three months of treatment. Clomiphene tablets maybe combined with steroid tablets to suppress androgen production. If this fails after a six month trial, then controlled ovarian stimulation with FSH or hMG combined with hCG is used. Because the polycystic ovaries are usually sensitive to stimulation by hormones, it is important to start with a low dose and adjust the dose according to the response. Monitoring of treatment is essential because these patients are susceptible to develop ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy.

Surgery

Surgery is recommended should the medical treatment fail and for women who have experienced OHSS. This may be ovarian drilling or ovarian wedge resection. It is not clear why 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 is in the region of 40-60%. There is no increased risk of multiple pregnancy or OHSS. 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 persistance 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 anesthesia.



Treatment of Polycystic Ovarian Syndrome (PCOS) in women who do not wish to conceive

Low-dose contraceptive pills are the best option to restore menstrual regularity. It will decrease ovarian hormone production and help reverse the effects of the excessive androgen levels. However, if you smoke and are over 35 years, birth control pills are not recommended. The doctor may prescribe other hormone treatments such as progesterone tablets. In women with hirsutism or severe acne, treatment with estrogens and anti-androgen such as cyproterone acetate (dianette) may be used.

Metformin

Many women with PCOS have decreased sensitivity to insulin, and their bodies overcompensate by over-producing insulin. Elevated levels of insulin are common in women with PCOS, whether they are obese or thin compared with weight matched controls. Some experts believe that this excess insulin is the underlying cause of PCOS because insulin stimulates androgen production and effects follicular development. As a consequence, Metformin (oral anti-diabetic drug) combined with Clomid, has been used to treat women with PCOS. The results of the treatment are encouraging. It successively restored regular menstrual cycles and fertility. Insulin sensitizing drugs have not been licensed in the UK for use in non diabetic patients. Metformin should not be used when kidney function is abnormal. Further research is needed to evaluate the efficacy, safety, and long term

This is for information only, it is important that you continue to consult your healthcare professional to make sensible diagnosis and treatments.