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Before You Have Surgery for PCOS

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Updated August 11, 2009

Polycystic ovary syndrome (PCOS) is a complicated hormonal disorder affecting many different body systems. Besides affecting a woman's menstrual cycle and fertility, her risk for heart disease and diabetes are increased as well. If medications have not been successful, your physician may suggest having surgery for PCOS as an option.

While surgery was once the primary treatment for PCOS, it is not commonly used anymore due to the risk of ovarian damage. There are many things you should think about and ask your doctor about before having surgery. Getting a second opinion is strongly recommended as well.

Besides surgery, what other options are available to treat PCOS?

Before considering surgery, a number of medical treatments should be discussed or attempted: weight loss, birth control pills, spironolactone and symptom management. Surgery is only typically recommended once these treatments are no longer effective or tolerated.

What Kind of Procedures are Used?

Two types of surgical interventions have been used to treat PCOS: ovarian wedge resection and laparoscopic ovarian drilling. It is important to know that most physicians strongly recommend against having wedge resection due to the risk of scarring on the ovary. In fact, it is almost never performed anymore. If the procedure is suggested, it is definitely worth getting a second opinion.

Will Having Ovarian Drilling or Wedge Resection Help Me Get Pregnant?

There have been circumstances where some women have had regular menstrual cycles in the months following surgery and even some pregnancies. Generally speaking, the risk of adhesions or scar tissue on the ovary is far greater then the percentage of women who achieved a pregnancy after ovarian drilling.

Are There Risks to Having Wedge Resection or Ovarian Drilling?

As with any surgery, there are risks. Besides the risk associated with anesthesia, lower abdominal pain, bleeding, damage or scarring of the reproductive organs and infection may result. To minimize these risks, select a physician who has a lot of experience performing this procedure.

Would Removing my Ovaries Cure the Disease?

Many women wonder if simply removing the ovaries will cure the syndrome. It is true that the ovaries are responsible for some of the androgen production in women. However, while removing one or both ovaries may reduce some of the androgen production and therefore some of the symptoms, it will not cure the disease. PCOS is more than an ovarian dysfunction, and affects many different organ and hormonal systems.

What Questions Should I Ask the Doctor?

Before considering surgery, have a long discussion with your doctor about why he feels surgery is appropriate, what his experiences using ovarian drilling are, how many times he's done the procedure and what his success rates are.
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