Ultrasound-guided aspiration of endometriomas: possible applications and limitations

Zanetta, Gerardo; Lissoni, Andrea Alberto; Valle, Cristina Dalla; Trio, Diego; Pittelli, M. R.; Rangoni, G.

doi:10.1016/s0015-0282(16)57843-1

Cited by 58 publications

(47 citation statements)

References 16 publications

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“…Aspiration guided by transvaginal ultrasonography was proposed in 1991 (7,8) as an option for patients who refused the operation or if there was a contraindication for surgery. Aspiration is a less invasive, quicker, and less expensive procedure than surgery (17) , but it has a greater rate of recurrence and has restrictions on its broader application. Currently, the use of sclerosing substances has been proposed following aspiration with substances including tetracycline (9) , methotrexate (10) , interleukin 2 (18) , and ethanol (11) .…”

Section: Discussionmentioning

confidence: 99%

Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization – a pilot study

Andre

Vilariño

Christofolini

et al. 2011

Einstein (São Paulo)

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Objective: To describe the evolution of controlled ovarian hyperstimulation in women with recurrent ovarian endometriomas treated with sclerotherapy. Methods: Twenty-one patients with a laparoscopic diagnosis of stage III or IV endometriosis who had an endometrioma larger than 3 cm before ovarian hyperstimulation for in vitro fertilization were included in the study. After using a GnRH agonist analog for at least 20 days, the cysts were punctured using ultrasound guidance and subsequent ethanol sclerotherapy was performed. Then, the patients were stimulated with 100 or 200 U/day of recombinant follicle stimulating hormone, varying the dose according to the patient's age or history of a previous unilateral oophorectomy. Results: The ovarian cysts had an average diameter of 4.7 ± 1.4 cm and did not recur after aspiration during the ovulation induction. Oocyte extraction occurred after 11 days of hyperstimulation, with 3.95 ± 3.30 oocytes obtained per cycle, on average. Embryo transfer occurred in 71.4% (15/21) of patients, and the pregnancy rate after transfer was 20% (3/15). Conclusion: Aspiration followed by ethanol sclerotherapy prior to in vitro fertilization can be an option for patients who desire a pregnancy and have recurrent endometriomas.

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Section: Discussionmentioning

confidence: 99%

Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization – a pilot study

Andre

Vilariño

Christofolini

et al. 2011

Einstein (São Paulo)

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“…Therefore its aspiration could also contribute to curing endometriosis. Certainly, some reports [4,5] have proposed US-guided aspiration of ovarian endometriomas as an alternative treatment when surgery is undesired or contraindicated, but drainage alone seems to be ineffective [3,5,6] and could enhance adhesion formation [6,24]. However, drainage followed by GnRH analogues was effective in the reduction of cyst size and glandular mitotic activity [3].…”

Section: Discussionmentioning

confidence: 99%

“…With this aim in mind, GnRH analogues are usually administered for 3-6 months. Likewise, some reports [4,5] have proposed ultrasound (US)-guided aspiration of ovarian endometriomas as an alternative treatment when surgery is undesired or contraindicated, whereas drainage alone seems to be ineffective [3,5,6].…”

Section: Introductionmentioning

confidence: 99%

GnRH Analogues, Transvaginal Ultrasound-Guided Drainage and Intracystic Injection of Recombinant Interleukin-2 in the Treatment of Endometriosis

Acién

Quereda

Gómez‐Torres

et al. 2003

Gynecol Obstet Invest

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We performed a double-blind, randomised controlled trial to evaluate the results of ultrasound-guided aspiration of endometriomas under the effect of GnRH analogues and a possible additional beneficial effect by leaving 600,000 IU of recombinant interleukin-2 (rIL-2) in the cysts. Twenty-four women with endometriosis-related symptoms, increased values of CA-125 and transvaginal ultrasonography showing endometriomas >3 cm who were initially sent to us for laparotomy and conservative surgery for endometriosis were included. Main outcome measures were severity of symptoms, size and percentage of echographical reduction of endometriomas and CA-125 levels after 2 menses post-GnRH analogues. Secondary outcome measures were the time until recurrence of abnormal parameters and the need for surgery after treatment. We found moderate clinical results after treatment with drainage plus GnRH analogues and significantly improved results in women having received rIL-2 intracystically. There were no side effects. Two out of 3 previously infertile patients became pregnant after therapy. Though the rates of recurrence of endometriomas ≧3 cm were similar in both groups, the period until recurrence was significantly greater when rIL-2 was used, and the rates of recurrence of symptoms and increased CA-125 values were also significantly lower in patients who received rIL-2. Surgery was finally performed on 10 patients (4 with and 6 without previous rIL-2 treatment) during follow-up (30 ± 12.7 months). These findings led to the conclusion that transvaginal ultrasound-guided puncture and aspiration of endometriomas under endometrial suppressive therapy with GnRH analogues have some value for endometriosis treatment, improving the clinical manifestations and avoiding some surgical therapies, and that rIL-2 left in the cyst increases these beneficial effects significantly.

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“…Endometriosis may occur rarely at scar site in the lower abdominal wall following operations on the uterus or fallopian tubes or episiotomy scar. [2][3][4][5][6][7][8][9][10] Endometriosis may be asymptomatic or symptoms like subfertility, dysmenorrhea, dyspareunia or chronic pelvic pain may occur. Endometriosis associated with scar presents as a swelling or nodule, which may occur after few weeks to years following surgery.…”

Section: Introductionmentioning

confidence: 99%

Perianal Endometriosis: A Case Report and Our Clinical Experience.

Kundan¹,

Kumari²,

Krishna³

et al. 2017

IOSR JDMS

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Ultrasound-guided aspiration of endometriomas: possible applications and limitations

Cited by 58 publications

References 16 publications

Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization – a pilot study

Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization – a pilot study

GnRH Analogues, Transvaginal Ultrasound-Guided Drainage and Intracystic Injection of Recombinant Interleukin-2 in the Treatment of Endometriosis

Perianal Endometriosis: A Case Report and Our Clinical Experience.

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