Ultrasound-Guided Aspiration With and Without Ethanol Sclerotherapy in the Management of Simple Adnexal Cysts: A Single-Center Experience.
OBJECTIVE
To compare the efficacy of ultrasound-guided aspiration versus aspiration with ethanol sclerotherapy in the management of simple adnexal cysts measuring 3 to 10 cm, and to explore the risk factors for recurrence associated with each approach.


METHODS
A prospective follow-up of patients after cyst aspiration with and without ethanol sclerotherapy in simple adnexal cysts in a single-center trial (Canadian Task Force classification II-1).


METHODS
Bellvitge Teaching Hospital, Barcelona, Spain.


METHODS
Cyst aspiration and ethanol sclerotherapy were performed in 66 and 75 patients, respectively, between 2002 and 2014. Women enrolled before March 2009 underwent simple aspiration (group 1), and those enrolled after March 2009 underwent ethanol sclerotherapy (group 2).


METHODS
Ultrasound-guided fine-needle aspiration with and without ethanol sclerotherapy.


RESULTS
Potential risk factors for recurrence-age, menopausal status, symptoms, cyst diameter, laterality, aspirated volume, simple US-guided aspiration or alcohol sclerotherapy, and complications-were analyzed by logistic regression. The recurrence rates were analyzed by the Kaplan-Meier and Mantel-Haenszel methods. The overall recurrence rates were 72.7% (48 of 66) in group 1 and 22.7% (17 of 75) in group 2 (p < .0001). Risk factors significantly associated with recurrence were simple aspiration without ethanol sclerotherapy (odds ratio [OR], 19.7; 95% confidence interval [CI], 6.756-57.714), postmenopausal status (OR, 9.3; 95% CI, 1.720-50.956), and cyst size (OR, 1.04; 95% CI, 1.005-1.093).


CONCLUSIONS
Based on the lower recurrence rate, ethanol sclerotherapy was more efficacious than simple aspiration in the management of simple adnexal cysts measuring <10 cm.
Consorci Sanitari Integral, Obstetrics and Gynecology, Hospitalet de Llobregat, Barcelona, Spain; Department of Obstetrics and Gynecology, Universitat Autonoma de Barcelona, Barcelona, Spain. Electronic address: Marta.Castellarnau@sanitatintegral.org.
Marta
M
Castellarnau
Department of Gynecology, Bellvitge Teaching Hospital, Barcelona, Spain.
Amparo
A
García-Tejedor
Department of Obstetrics and Gynecology, Universitat Autonoma de Barcelona, Barcelona, Spain; Department of Obstetrics and Gynecology, Parc de Salut Mar, Barcelona, Spain.
Ramon
R
Carreras
Consorci Sanitari Integral, Obstetrics and Gynecology, Hospitalet de Llobregat, Barcelona, Spain.
Enric
E
Cayuela
Department of Gynecology, Bellvitge Teaching Hospital, Barcelona, Spain.
Jordi
J
Ponce
D000291:Adnexal Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D000368:Aged; D044963:Biopsy, Fine-Needle; D003560:Cysts / Q000473:pathology*; D019468:Disease Management; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D012597:Sclerosing Solutions; D000431:Ethanol
Ethanol sclerotherapy; Fine-needle aspiration; Management; Simple adnexal cyst; Ultrasound