Effectiveness of ultrasound-guided aspiration and sclerotherapy with 95% ethanol for treatment of recurrent ovarian endometriomas.
OBJECTIVE
To evaluate the effectiveness of transvaginal ultrasound aspiration and ethanol sclerotherapy in patients with recurrent ovarian endometriomas.


METHODS
Retrospective study.


METHODS
Teaching hospital affiliated with Chang Gung University, Taipei.


METHODS
Patients (n = 108) with recurrent ovarian endometriomas >or=3 cm.


METHODS
Preoperative evaluation of previous pathology, midcycle serum CA-125 level, and color Doppler ultrasonography to exclude possibility of malignancies. After aspiration, sclerotherapy with 95% ethanol irrigation of the cystic cavity was performed (group 1, n = 78, 0-10 minutes of retention; group 2, n = 30, ethanol left in situ [retention]).


METHODS
Ultrasonography was performed at 3, 6, 9, and 12 months to determine persistence and size of cysts and the number of antral follicles. Pelvic pain score was also determined at those time points.


RESULTS
The 1-year recurrence rate for group 2 patients was significantly lower than for group 1 patients (13.3% vs. 32.1%). Antral follicle count was increased and pain score was decreased in both groups to a similar level. No significant change in CA-125 was observed.


CONCLUSIONS
Ultrasound-guided sclerotherapy with 95% ethanol is an effective therapy for ovarian endometriomas. Retention of ethanol is more effective than irrigation only.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Chia-Lin
CL
Hsieh
Chii-Shinn
CS
Shiau
Liang-Ming
LM
Lo
T'sang-T'ang
TT
Hsieh
Ming-Yang
MY
Chang
D000328:Adult; D001707:Biopsy, Needle / Q000379:methods*; D018394:CA-125 Antigen / Q000097:blood; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D010045:Outpatients; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D010146:Pain / Q000503:physiopathology; D010147:Pain Measurement; D012008:Recurrence; D012189:Retrospective Studies; D015911:Sclerotherapy / Q000379:methods*; D014463:Ultrasonography / Q000379:methods
D018394:CA-125 Antigen; D000431:Ethanol