子宮内膜症に対するYAGレーザーバルーン蒸散法の試み

抄録

Me report a case of YAG Laser vaporization for residual endometrial ovarian cyst which had been treated by LH-RHa for 10 month.
The case was 37-years-old, P (1) G (1). She consulted our hospital because of severe algomenorrhea. By pelvic examination severe tenderness of Douglas pouch and left ovarian cyst was found out and bilateral ovarian cysts were revealed by CT, echo image. Serum level of CA-125 was 56U/ML, CA19-9 was 43U/ML. She had been treated by LH-RHa for 10 month on the diagnosis of bilateral ovarian chocolate cysts and pelvic endometriosis.
The size of ovarian cysts was redused and her complains of algomenorrhea was softened. But 4 month later algomenorrhea and tenderness of duoglas pouch recurred. After, successing of treatment by LH-RHa for 4 month laparoscopy was done.
By findings of pelvic cavity, left ovary was enlarged as over hens egg sized and adhered to douglas pouch. This adhesion was convinced as the cause of recurred algomenorrhea. After punctation of the surfase of the left ovary and absorption of the chocolate contents, latex balloon named. VP-16 was inserted and swelled by 15ml saline solution and was oppressed to the ovarian surface. YAG laser was irradiated through the balloon by output power of 10 watts for 5 minutes. The inner surface was degenerated evenly. Me incised a part of it and confirmed degeneration by microscopy. During all these procedure there was no apparent side effects.
After this procedure algomenorrhea was diminished and ovarian enlargement has not been observed.