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

Abstract

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 ...

Comparison of the efficacy between bilateral proximal tubal occlusion and total salpingectomy on ovarian reserve and the cholinergic system: an experimental study

“…In the calculation of the ovarian reserve, ovarian follicles were defined with the method described by Mazaud [21]. The fibrosis was assessed with Masson's trichrome staining and scored from 0 to 3 semiquantitatively as follows: 0 = no fibrosis, +1 = low fibrosis, +2 = intermediate fibrosis, +3 = severe fibrosis [22].…”