Impact of intracystic ethanol instillation on ovarian cyst diameter and adjacent ovarian tissue

Atılgan, Remzi; Ozkan, Zehra Sema; Kuloğlu, Tuncay; Kocaman, Nevin; Başpınar, Melike Mercan; Can, Behzat; Şi̇mşek, Mehmet; Sapmaz, Ekrem

doi:10.1016/j.ejogrb.2013.12.019

Cited by 15 publications

(13 citation statements)

References 30 publications

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“…Previous experimental studies have shown that left total salpingectomy was associated with reduced rate of decrease in angiogenesis, increased number of atretic follicles, increased ovarian stromal fibrosis, and development of macroscopic follicular cysts. 14 , 15 , 20 In our experiment, following unilateral total salpingectomy, macroscopic ovarian cysts were formed in 70% of the cases. In our study, ethanol was administered at a volume of approximately 50% of the aspirated fluid from the cyst and was aspirated back after 5 minutes.…”

Section: Discussionmentioning

confidence: 48%

“…Similarly Yazbeck et al 26 found no negative effects of EST on ovarian reserve. In an experimental study by Atilgan et al 15 the duration of administration was 10 minutes, with significant reduction in the size of the ovarian cysts 1 month after treatment. However, they also detected significant fibrosis and apoptosis in the ovarian tissues along with reduced ovarian reserve.…”

Section: Discussionmentioning

confidence: 99%

“…In order to induce the development of ovarian cysts, the method proposed by Atilgan et al was used. 14 , 15 After unilateral total salpingectomy was performed and hemostasis was achieved, the incision was closed using 3-0 silk with single sutures. One month after the initial procedure, abdominal cavities were reopened and formation of macroscopic ovarian cysts was detected in 14 (70%) rats ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

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The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts

Şi̇mşek¹,

Kuloğlu²,

Pala³

et al. 2015

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ObjectivesTo examine the effect of 95% ethanol sclerotherapy (EST) administered over 5 minutes on cyst diameter and ovarian tissue in experimentally induced simple ovarian cysts in a rat model.Materials and methodsIn order to induce ovarian cysts, unilateral total salpingectomy was performed in regularly menstruating adult female Wistar albino rats (n=20) between 12 and 14 weeks of age and weighing between 200 and 220 g. One month after the procedure, the abdominal cavity was opened and 14 rats (70%) were found to have developed macroscopic cysts. Rats with macroscopic cysts (n=14) were assigned into two groups in a prospective and single-blinded manner: group 1 (G1) (n=7), control rats; and group 2 (G2) (n=7), 5-minute EST 95% group. Cyst diameter was measured and recorded for each rat. In G2, after whole cyst fluid was aspirated the cystic cavity was irrigated with 95% ethanol, approximately equal to half of the aspirated cyst volume, after which an interval of 5 minutes was allowed and same amount was re-aspirated and the abdominal cavity was closed. One month after this procedure, abdominal cavities were reopened and intra-abdominal adhesion scoring was performed in both groups. Cyst diameter was measured for each rat, and the right ovary was removed, fixed in 10% formaldehyde, and transported to the laboratory. A histologic assessment of the ovarian tissues was performed under light microscopy following staining with hematoxylin and eosin. Mann–Whitney U-test was used for statistical analysis. A P-level less than 0.05 was considered significant.ResultsIn comparison with G1, there was a statistically significant reduction in the mean ovarian cyst dimensions in G2, while there were no significant differences between the two groups with respect to total number of follicles. Again, a significant increase in apoptotic activity and germinal epithelial degeneration was observed in G2 as compared to G1. The two groups were similar in terms of adhesion formation.ConclusionAlthough 95% EST results in a reduction in the size of simple ovarian cysts, this effect seems to be achieved at the expense of ovarian tissue injury.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts

Şi̇mşek¹,

Kuloğlu²,

Pala³

et al. 2015

DDDT

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“…This may explain the similar follicle numbers determined in the groups despite the differences in congestion and fibrosis. Thus, these results show that ethanol sclerotherapy as administered by Atilgan et al (20) was more destructive than PI sclerotherapy, and PI can be used more safely in simple ovarian cysts.…”

Section: Groups Fibrosis Congestionmentioning

confidence: 59%

Investigation of treatment efficacy of 10% povidone–iodine sclerotherapy on ovarian cyst diameter: an experimental study

2019

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Introduction Ovarian cysts are common, affecting 20% of women at some point in their lives (1). Unlike unilocular cysts including septations, solid irregular wall, or internal plaques, the simple ovarian cyst is defined as an anechoic round or oval lesion (2). The maximum diameter of simple ovarian cysts in premenopausal women is less than 5 cm; they often disappear during the menstrual cycle and do not require further intervention. Larger cysts (5-7 cm) should be followed using ultrasonography. Cysts larger than 7 cm may require advanced imaging or surgery (3). In the treatment protocols for benign ovarian cysts, methods such as medical treatment (especially oral contraceptives), ultrasound-guided aspiration, laparoscopy (cystectomy or ablation of drainage and cystic wall), and laparotomy (cystectomy) are used (4,5). Sclerotherapy can be used for women who have ovarian cysts but want to protect their fertility and do not want surgical treatment (6). It has been reported that sclerotherapy has many advantages such as minimal trauma, lower surgical risks and complications, low cost, and reduced recurrence rates (7,8). USG-guided aspiration and sclerotherapy have been reported as a low-cost and effective treatment for benign cysts localized in other organs such as the thyroid, parathyroid, liver, kidney, and spleen (9). Tetracycline, methotrexate, and ethanol are the most common agents used for sclerotherapy. When compared to women without cysts, sclerotherapy applied to infertile women with ovarian cysts has been shown to reduce pelvic pain without affecting the number of follicles, term pregnancy and abortion rates, the number of obtained oocytes, embryo quality, or hormonal levels (10-13). Compared to other sclerosing agents, povidone-iodine (PI) is a less toxic, less irritating, economical, and readily available agent. In addition to local antiseptic, antibacterial, and antifungal effects, it has a sclerotherapeutic effect, and preparation of it at the desired concentration is easy (14). Background/aim: The purpose of this study was to investigate the effects of 10% povidone-iodine (PI) sclerotherapy on ovarian cyst diameter through an experimental study. Materials and methods: To be able to create ovarian cysts, right unilateral salpingectomy was performed on 20 Wistar albino rats. One month after the operation, the abdomens of all rats were reopened. Sixteen rats with macroscopic ovarian cysts were divided randomly into 2 groups consisting of 8 rats. Group 1 (G1): the cyst content was only aspirated. Group 2 (G2): the ovarian cyst was aspirated and then the cystic cavity was irrigated with PI. Abdomens of all rats were closed and 1 month later they were reopened. Tissues of the right ovaries of the rats were embedded in paraffin blocks for histopathological examination. Follicle count, fibrosis, and congestion were evaluated under a light microscope. Results: For G1, there was no difference in cyst diameters before and after aspiration. In G2, a decrease was observed in cyst diameter. There was no difference ...

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“…Ethanol rapidly coagulates the active endothelial cells lining the cyst wall but penetrates the fibrous capsule slowly causing minimal local or systemic complications [4]. However, in an experimental controlled animal study, Atilgan et al [5] shed lights on the possible damage level of adjacent ovarian reserve in rats after local ethanol application through inducing fibrosis and apoptosis. As yet, no data are available in the literature concerning its effect on the ovarian reserve in human as well as its long-term sequelae especially in women suffering from infertility.…”

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confidence: 99%

Letter to the Editor: Re: Comparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy

Shokeir

2014

Clin Exp Reprod Med

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Impact of intracystic ethanol instillation on ovarian cyst diameter and adjacent ovarian tissue

Cited by 15 publications

References 30 publications

The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts

The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts

Investigation of treatment efficacy of 10% povidone–iodine sclerotherapy on ovarian cyst diameter: an experimental study

Letter to the Editor: Re: Comparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy

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