title: In situ methotrexate injection for treatment of recurrent endometriotic cysts.
abstract: 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.
authors.affiliation: Service de Gynécologie, Hôpital La Conception, 147 Boulevard Baille, 13385 Marseille, France. aagostini@mail.ap-hm.fr
authors.forename: Aubert
authors.initials: A
authors.lastname: Agostini
authors.forename: Thomas
authors.initials: T
authors.lastname: De Lapparent
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Collette
authors.forename: Mariane
authors.initials: M
authors.lastname: Capelle
authors.forename: Ludovic
authors.initials: L
authors.lastname: Cravello
authors.forename: Bernard
authors.initials: B
authors.lastname: Blanc
mesh_terms: 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
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate