Ultrasound-guided aspiration of endometriomas: possible applications and limitations.
OBJECTIVE
To evaluate the role of needle aspiration in the management of endometriomas.


METHODS
Retrospective evaluation of the activity of the section of interventional ultrasound in a single tertiary care institution.


METHODS
Department of Obstetrics and Gynecology, Ospedale S. Gerardo, Monza, University of Milan, Italy.


METHODS
Two hundred nine premenopausal patients underwent aspiration for diagnostic purpose (n = 166), for relief of symptoms (n = 25), or with therapeutic intent (n = 18).


RESULTS
Adequate material was obtained by all punctures. Early complications (self-limiting vagal symptoms or pain) occurred in eight cases. Short-term complications consisted of acute abdominal pain in three cases and infection in one. Three women required surgical treatment of the complication. At first examination after aspiration, persistence of the cyst was observed in all but four cases, including all cases who had undergone therapeutic aspiration. Nine patients reported relief of symptoms but six other patients referred onset or worsening of pelvic discomfort after aspiration.


CONCLUSIONS
Ultrasound-guided aspiration of endometriomas is feasible. The transvaginal route reduces early complication but implies a risk of infection of 1.3%. However, drainage alone is ineffective as a therapeutic procedure and the applications of aspiration of endometriomas appear limited to some cases with diagnostic intent.
Zanetta
G
G
Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.
Lissoni
A
A
Dalla Valle
C
C
Trio
D
D
Pittelli
M
M
Rangoni
G
G
D000328:Adult; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D011677:Punctures; D012008:Recurrence; D012189:Retrospective Studies; D014463:Ultrasonography