In situ methotrexate injection after transvaginal ultrasound-guided aspiration of ovarian endometriomas: A randomized controlled trial

Shawki, Hossam Eldin; Elmorsi, Mahmoud; Samir, Ahmed; Eissa, Mostafa K.

doi:10.1016/j.mefs.2011.02.002

Cited by 14 publications

(21 citation statements)

References 22 publications

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“…Catheter-based sclerotherapy with 95% ethanol or in situ methotrexate injection is simple, safe, non-invasive and effective in the treatment of selected cases of ovarian endometriomas and ovarian function is also well-preserved in these patients. It has been seen that during a follow-up of about 12.7 months, there was no recurrences of endometrioma and pain was also relieved in all patients [11,12].…”

Section: Discussionmentioning

confidence: 83%

Untitled

2017

RMGO

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Objective: Management of large ovarian endometriomas has been a potential challenge; be it laparoscopy, open approach or drainage of the cystic fluid. The present procedure has been carried out to benefit young yet to conceive patients to restore ovarian function and facilitate conception. Case series: 3 patients; one presented with history of increasing abdominal girth, pain and infertility; the other with history of loose motion and acute abdominal pain; the third patient had complaints of abdominal pain and infertility. Radiological investigations revealed large cysts in the right and left ovary in the first and third patients respectively; bilateral complex cystic lesions in the second patient. The tumour markers were moderately high (endometriosis); imaging showed benign appearance. Ultrasound-guided drainage of the chocolate-coloured cystic fluid was done using a pigtail catheter. Postoperative period was uneventful. Conclusion: Minimally invasive treatment of endometrioma which benefits infertile or unmarried patients by preserving the ovaries and fertility henceforth.

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Section: Discussionmentioning

confidence: 83%

Untitled

2017

RMGO

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“…Chauffour et al 23 reported that ethanol sclerotherapy decreased the recurrence rate of endometriomas without altering the results of IVF while a second surgery would have had a deleterious effect. The use of in situ methotrexate 24–27 for the treatment of endometriomas has also been recommended.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes of transvaginal ultrasound‐guided aspiration versus traditional conservative surgery as treatment for endometriomas: A retrospective study of cohorts

Acién

Velasco

Quesada

et al. 2021

J of Obstet and Gynaecol

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Aim To evaluate if the long‐term results (on fertility, need of hysterectomy and persistence of endometriosis) after a minimally invasive intervention (transvaginal ultrasound‐guided puncture‐aspiration [TUGPA]) for endometriomas are significantly different from performing the traditional conservative surgery (CS) by laparoscopy or laparotomy. Methods We performed a retrospective study of cohorts on patients undergoing surgery for ovarian endometriomas between January 1998 and April 2015. Cohort 1 consisted of 75 women whose first intervention for endometriomas had been TUGPA. For the cohort 2, we selected a randomized paired case in which the first operation for endometriomas had been CS by laparoscopic or laparotomy (another set of 75 patients). Results There were significantly more recurrences and the time to recurrence and repetition of operations were also significantly shorter in patients with TUGPA. However, there were no significant differences in overall pregnancy/delivery outcomes, in hysterectomy performances, or in endometriosis persistence at the last follow‐up visit. There were no significant differences related to the symptoms or to analytical presurgical values but the application of multivariate analysis with binary logistic regression to each dependent variable adjusted for age, symptoms, and presurgical analyses showed a significant risk of recurrence and reoperation of TUGPA versus CS. Conclusions Those patients with endometriomas who underwent TUGPA (with or without associated medications) had a significant increase in recurrence and the need for reoperation. However, in the long‐term there were no significant differences in the results of pregnancy/childbirth, need for hysterectomy, or in the clinical or doubtful persistence of endometriosis.

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“…The risk of affecting the residual ovarian function with this procedure is low because methotrexate injection is intra-cystic and diffusion in the rest of ovary is limited [7]. The use of in situ methotrexate for ectopicpregnancy has never shown ovarian damage [12] [13].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Intra-Cystic Methotrexate Injection in Management of Benign Persistent Ovarian Cysts

Gergawy¹,

Halwagy²,

Dawood³

et al. 2017

OJOG

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Aim: To evaluate and compare the efficacy of methotrexate injection in management of persistent simple ovarian cyst versus the use of transvaginal ultrasound aspiration alone. Patients and Methods: This randomized controlled study was conducted at Tanta University Hospitals in the period from April 1, 2016 to October 31, 2016. Patients were randomly allocated into two groups; each group has 25 patients with benign persistent simple ovarian cyst. Group I: Patients were subjected to transvaginal aspiration of the cyst. Group II: patients were subjected to methotrexate injection inside the cyst. Patients in both group were followed up at 1, 3, 6 months after procedure for the recurrence and occurrence spontaneous pregnancy. Results: The mean age in group I was 28.8 years, and the mean age in group II was 26.52 years with non-significant difference. Also there was non-significant difference between both groups regarding size of the cyst. No case recorded to have a cyst recurrence in group II and four cases in group I within six months with significant difference (P value 0.037), and there was non-significant differences as regard the pregnancy rate and complications. Conclusion: Transvaginal intra-cystic methotrexate injection is a safe and effective choice for management of persistent simple benign ovarian cyst.

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In situ methotrexate injection after transvaginal ultrasound-guided aspiration of ovarian endometriomas: A randomized controlled trial

Cited by 14 publications

References 22 publications

Untitled

Untitled

Long‐term outcomes of transvaginal ultrasound‐guided aspiration versus traditional conservative surgery as treatment for endometriomas: A retrospective study of cohorts

Efficacy of Intra-Cystic Methotrexate Injection in Management of Benign Persistent Ovarian Cysts

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