Archives of Gynecology and Obstetrics

, Volume 294, Issue 4, pp 791–796 | Cite as

Post-operative ovarian adhesion formation after ovarian drilling: a randomized study comparing conventional laparoscopy and transvaginal hydrolaparoscopy

  • Pierluigi Giampaolino
  • Ilaria Morra
  • Giovanni Antonio Tommaselli
  • Costantino Di Carlo
  • Carmine Nappi
  • Giuseppe Bifulco
General Gynecology



To compare conventional laparoscopic ovarian drilling (LOD) with transvaginal hydrolaparoscopy (THL) ovarian drilling in terms of ovarian adhesion formation, evaluated using office THL during follow-up in CC-resistant anovulatory patients affected by PCOS.


Prospective randomized study on 246 CC-resistant women with PCOS. The patients enrolled were divided into two groups, 123 were scheduled to undergo LOD and 123 to undergo THL ovarian drilling. Six months after the procedure all patients were offered office transvaginal hydrolaparoscopy (THL) follow-up, under local anesthesia to evaluate adhesion formation.


Duration of the procedure was significantly shorter in the THL group in comparison with LOD group (p < 0.0001). No intra- or post-operative complication was observed in any of the patients in both groups. Post-operative THL follow-up after 6 months showed that 15 (15.5 %) patients in the THL group and 73 (70.2 %) in the LOD group showed the presence of ovarian adhesion. This difference was highly significant with a p value <0.0001 and a relative risk of 0.22 [95 % IC 0.133–0.350].


This study seems to indicate that THL ovarian drilling may reduce the risk of ovarian adhesion formation and could be used as a safe and effective option to reduce ovarian adhesion formation in patients undergoing ovarian drilling.


PCOS Ovarian drilling Office transvaginal hydrolaparoscopy Post-operative ovarian adhesions 


Compliance with ethical standards

All authors deny any financial and personal relationships with other people or organizations that could inappropriately influence their work and affirm that the manuscript has not published previously and is not being considered concurrently by another publication.

Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

All procedures performed in study were in accordance with the ethical standards of the our institutional research committee and with the 1964 Helsinki declaration.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of Obstetrics, Gynecology, and UrologyUniversity of Naples “Federico II”NaplesItaly
  2. 2.Department of Public HealthUniversity of Naples “Federico II”NaplesItaly

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