In situ methotrexate injection for treatment of recurrent endometriotic cysts.
OBJECTIVE
Ovarian endometrioma recurrence is frequent. Conventional treatment of ovarian endometrioma is by surgical cystectomy. We proposed an alternative medical treatment for recurrent ovarian endometrioma: cyst aspiration followed by in situ methotrexate injection.


METHODS
From January 2002 to May 2003, 14 patients with recurrent homolateral ovarian endometrioma underwent transvaginal ultrasound guided cyst puncture and aspiration followed by methotrexate injection, whilst under general anasthesia. Recurrence rate during follow up was evaluated.


RESULTS
No complication was reported. After a mean follow up of 20+/-5 month (min: 13, max: 29), four recurrences were diagnosed (28.6%). Two asymptomatic recurrences were not treated and two painful recurrences underwent a second cyst drainage with methotrexate injection.


CONCLUSIONS
In situ methotrexate injection is a simple, effective and an interesting alternative to surgical treatment in women with recurrent homolateral ovarian endometrioma.
Agostini
Aubert
A
Service de Gynécologie, Hôpital La Conception, 147 Boulevard Baille, 13385 Marseille, France. aagostini@mail.ap-hm.fr
De Lapparent
Thomas
T
Collette
Emmanuelle
E
Capelle
Mariane
M
Cravello
Ludovic
L
Blanc
Bernard
B
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000188:drug therapy*; D055502:Secondary Prevention; D014463:Ultrasonography
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate