Management of transvaginal ultrasound-guided absolute ethanol sclerotherapy for ovarian endometriotic cysts.
OBJECTIVE
Endometriosis and endometriotic ovarian cysts are common gynecologic diseases. Excision of the cyst wall by laparotomy or laparoscopy is the standard treatment for endometriotic ovarian cysts. However, some young patients with cysts would prefer not to have an abdominal incision. We reviewed and assessed the effectiveness of transvaginal ultrasound-guided ethanol sclerotherapy in these patients.


METHODS
Eighteen patients with endometriotic ovarian cysts underwent transvaginal ultrasound-guided aspiration and ethanol sclerotherapy using spinal anesthesia. The contents of the cysts were drained and sent for cytological examination. The cyst cavities were washed with absolute ethanol, and the cysts were then filled with absolute ethanol for 5 min. The patients were followed up with transvaginal ultrasonography.


RESULTS
The transvaginal ethanol sclerotherapy was completed in all cases. The mean long diameter of the cysts was 50 mm (31-100 mm), and the mean operative duration was 22 min (8-45 min). Malignant cells were not isolated from the aspirated fluid in any case. There were no significant intra- or postoperative complications. Two patients (11.1%) had a recurrence at 3 and 32 months after ethanol sclerotherapy, respectively.


CONCLUSIONS
Transvaginal ultrasound-guided absolute ethanol sclerotherapy is useful for ovarian endometriotic cysts, particularly in young patients or in patients who would like to become pregnant. However, careful selection based on ultrasonography or magnetic resonance imaging findings and the age of the patients is critical.
Department of Obstetrics and Gynecology, Terakata-Ikuno Hospital, Osaka, Japan. ikutaa@takii.kmu.ac.jp.|Department of Obstetrics and Gynecology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka, 570-8507, Japan. ikutaa@takii.kmu.ac.jp.
Akiko
A
Ikuta
Department of Obstetrics and Gynecology, Terakata-Ikuno Hospital, Osaka, Japan.
Yoshiaki
Y
Tanaka
Department of Obstetrics and Gynecology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka, 570-8507, Japan.
Tomomi
T
Mizokami
Department of Obstetrics and Gynecology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka, 570-8507, Japan.
Akihiro
A
Tsutsumi
Department of Internal Medicine, Terakata-Ikuno Hospital, Osaka, Japan.
Masahiro
M
Sato
Department of Obstetrics and Gynecology, Terakata-Ikuno Hospital, Osaka, Japan.
Maki
M
Tanaka
Department of Clinical Laboratory, Terakata-Ikuno Hospital, Osaka, Japan.
Hatsue
H
Kajihara
Department of Obstetrics and Gynecology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka, 570-8507, Japan.
Hideharu
H
Kanzaki
endometriosis; ethanol sclerotherapy; ovarian cyst; transvaginal ultrasonography