When Performing vNOTES Salpingectomy, Are We Damaging the Ovarian Reserve? Results From a Randomized, Controlled Trial
Journal of Minimally Invasive Gynecology, cilt.33, sa.7, ss.994-1000, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 33 Sayı: 7
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.jmig.2026.02.009
- Dergi Adı: Journal of Minimally Invasive Gynecology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.994-1000
- Anahtar Kelimeler: Epithelial ovarian cancer, Female sterilization, Natural orifice transluminal endoscopic surgery, Postoperative pain, Salpingectomy
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Study Objective: To compare the effects of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and conventional laparoscopy (CL) on ovarian reserve in women undergoing opportunistic bilateral salpingectomy (BS) for permanent sterilization. Design: Prospective randomized controlled trial. Setting: Tertiary care university hospital. Patients: Eighty-one women seeking permanent surgical sterilization were included; 35 underwent vNOTES salpingectomy and 46 underwent laparoscopic salpingectomy. Interventions: All participants underwent BS using either the vNOTES approach or conventional laparoscopy. Measurements and Main Results: Ovarian reserve was assessed using serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) measured preoperatively and at 3 months postoperatively. The 2 groups were comparable in terms of demographic characteristics. No statistically significant differences were observed between the vNOTES and CL groups regarding preoperative or postoperative 3-month AMH levels (p > .05), and repeated-measures ANOVA revealed no significant time × group interaction (p = .222). AFC values were also comparable between groups. Postoperative pain scores at 6 hours were significantly lower in the vNOTES group compared with the CL group (p < .001). Conclusion: vNOTES salpingectomy did not adversely affect ovarian reserve at 3 months compared with conventional laparoscopy, as assessed by AMH and AFC. Early postoperative pain scores were lower in the vNOTES group; however, pain was a secondary outcome. Larger studies with longer follow-up are warranted. ClinicalTrials.gov: NCT07177144, Date: 15/06/2025