title: Impact of intracystic ethanol instillation on ovarian cyst diameter and adjacent ovarian tissue.
abstract: OBJECTIVE
  To investigate the regression level of simple ovarian cyst size after local ethanol application and the damage level of adjacent ovarian reserve in rats.
  
  
  METHODS
  This study was conducted at Firat University Animal Laboratory with 18 mature (12-14 weeks old) female Wistar albino rats weighing 200-220g, with regular cycles. Ovarian cyst induction was performed with unilateral salpingectomy. Fourteen rats with ovarian cysts after a second laparotomy were divided into two groups as follows: Group 1 (n=7): cyst aspiration group, and Group 2 (n=7): intracystic 95% ethanol application group. One month after the cyst aspiration procedure a third laparotomy was performed. The cyst number and size were recorded for each rat. Right ovariectomy was performed and formalin-fixed/paraffin-embedded tissues were sectioned at 5μm thickness. Under light microscopy, ovarian total follicle reserve and fibrosis were evaluated with Masson trichrome staining and apoptosis was evaluated with TUNEL staining. The groups were compared with the Mann-Whitney U test and Wilcoxon Rank test. p<0.05 was considered significant.
  
  
  RESULTS
  Ovarian cyst formation was observed in 85% (15/18) of rats. The mean diameter of ovarian cysts in Groups 1 and 2 were, respectively, 10.3mm and 10.1mm. After aspiration, there was no significant reduction in the cyst diameter (10.3mm vs 8.1mm), but after ethanol application the diameter significantly reduced (10.1mm vs 3.4mm, p<0.05). Mean ovarian follicle count in Group 2 was significantly lower than in Group 1 (25 vs 42, p<0.05), and mean fibrosis and apoptosis scores in Group 2 were significantly higher than in Group 1 (2.5 vs 0.9, p<0.05).
  
  
  CONCLUSIONS
  Local ethanol application reduces cyst diameter but concomitantly decreases ovarian reserve due to increased fibrosis in rats. In humans, intracystic ethanol application should be performed cautiously.
authors.affiliation: Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey.
authors.forename: Remzi
authors.initials: R
authors.lastname: Atilgan
authors.affiliation: Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey. Electronic address: zehrasema@yahoo.com.
authors.forename: Zehra Sema
authors.initials: ZS
authors.lastname: Ozkan
authors.affiliation: Firat University School of Medicine, Department of Histology and Embryology, 23119 Elazig, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Kuloglu
authors.affiliation: Firat University School of Medicine, Department of Histology and Embryology, 23119 Elazig, Turkey.
authors.forename: Nevin
authors.initials: N
authors.lastname: Kocaman
authors.affiliation: Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey.
authors.forename: Melike
authors.initials: M
authors.lastname: Baspinar
authors.affiliation: Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey.
authors.forename: Behzat
authors.initials: B
authors.lastname: Can
authors.affiliation: Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Şimşek
authors.affiliation: Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Sapmaz
mesh_terms: D000818:Animals; D017209:Apoptosis; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D005355:Fibrosis; D020287:In Situ Nick-End Labeling; D010048:Ovarian Cysts / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D006080:Ovarian Follicle / Q000473:pathology; D010053:Ovary / Q000473:pathology*; D051381:Rats; D017208:Rats, Wistar; D058994:Salpingectomy
chemical_list: D000431:Ethanol
keywords: Apoptosis; Ethanol sclerotherapy; Ovarian reserve; Salpingectomy