title: Treatment of endometriosis with transvaginal ultrasound-guided drainage under GnRH analogues and recombinant interleukin-2 left in the cysts.
abstract: BACKGROUND
  To analyze the therapeutic results of one dose of 3 million IU of recombinant interleukin-2 (rIL-2) left intracyst (group I) versus two doses with a 1-month interval (group II) after transvaginal ultrasound (US)-guided drainage of endometriomas under the effect of GnRH analogues.
  
  
  METHODS
  Prospective and randomized clinical trial (helped by a random number table) at a University Hospital. Twenty-four consecutive patients with endometriomas initially sent to us for laparotomy and conservative surgery for endometriosis were included.
  
  
  METHODS
  Treatment with GnRH analogues every 28 days, 3 doses. Under their effect, one or two transvaginal US-guided punctures were performed in order to aspirate the endometriomas, and 3 million IU of rIL-2 were left in the aspirated cysts each time.
  
  
  METHODS
  
  
  
  RESULTS
  two menstruations after GnRH analogues. Other secondary outcome measures were: the time until recurrence of cysts, symptoms and CA-125 >35 U/ml, and the need for further medical or surgical treatment.
  
  
  RESULTS
  They were moderate or good in >50% of cases with one drainage and one dose of 3 million IU of rIL-2 intracyst, but were better with a second drainage and two doses of rIL-2 (25 vs. 58.3% 'good results'). There were fewer recurrences and the interval before recurrence was longer after two doses but differences were not significant. Six patients from group I (50%) and 3 from group II (25%) needed laparotomy and conservative surgery at 17.5 +/- 8.7 months (total time of follow-up = 33 +/- 8.8 months).
  
  
  CONCLUSIONS
  Treatment of endometriomas with transvaginal US-guided drainage and rIL-2 left in the cysts under endometrial suppressive therapy with GnRH analogues has beneficial effects, improving clinical manifestations and avoiding some surgical therapies. The use of a higher dose of rIL-2 does not produce better results, whereas drainage + rIL-2 twice does.
authors.affiliation: Service of Obstetrics and Gynecology, San Juan University Hospital and Department of Gynecology, School of Medicine, Miguel Hernandez University, Campus of San Juan, Alicante, Spain. acien@umh.es
authors.forename: Pedro
authors.initials: P
authors.lastname: Acién
authors.forename: Gloria
authors.initials: G
authors.lastname: Pérez-Albert
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Quereda
authors.forename: Marisa
authors.initials: M
authors.lastname: Sánchez-Ferrer
authors.forename: Ana
authors.initials: A
authors.lastname: García-Almela
authors.forename: Irene
authors.initials: I
authors.lastname: Velasco
mesh_terms: D000287:Administration, Topical; D000328:Adult; D004322:Drainage / Q000379:methods; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000627:therapeutic use*; D014463:Ultrasonography
chemical_list: D007376:Interleukin-2; D011994:Recombinant Proteins; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone