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1.
Chan LY So WW Lao TT 《European journal of obstetrics, gynecology, and reproductive biology》2003,109(2):196-198
OBJECTIVE: Ultrasound-guided aspiration is a less invasive management option for recurrent endometrioma. We postulated that the endometriotic tissue in the epithelial lining of endometrioma had undergone pressure atrophy after a period of observation, and resolution of the endometrioma can be achieved by aspiration of its content. STUDY DESIGN: A prospective study was carried out in which patients with recurrent endometrioma that remain stationary in size for a period of at least 6 months were included. Ultrasound-guided aspiration of endometrioma was performed transvaginally under conscious sedation. Ultrasound scan examination was performed at 1, 3, 6, and 12 months after aspiration to detect recurrence. RESULTS: Eight endometriomas were aspirated in six patients. The mean diameter and volume of endometrioma at aspiration were 31.0 mm (range, 18.0-46.3 mm) and 21.9 ml (range, 3.16-52.0 ml), respectively. There were no major complications. Cytological examination revealed hemosiderin-laden macrophages; neither malignant cells nor endometrial cells were detected in all cases. Six ovarian cysts recurred in five women (83.3%), all recurrence were detected within 3 months after aspiration. CONCLUSION: We concluded that although transvaginal ultrasound-guided aspiration is a safe procedure, but the recurrence rate after aspiration is unacceptably high, and hence cannot be recommended as a treatment option for recurrent endometrioma. 相似文献
2.
Ovarian abscess caused by Peptostreptococcus magnus following transvaginal ultrasound-guided aspiration of ovarian endometrioma and fixation with pure ethanol.
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H Mikamo K Kawazoe Y Sato M Itoh T Tamaya 《Infectious diseases in obstetrics and gynecology》1998,6(2):66-68
BACKGROUND: Transvaginal ultrasound-guided aspiration of ovarian endometrioma has been applied and emphasized as a safe and simple procedure. CASE: Two 27-year-old infertile women, both gravida 0, para 0, underwent medical follow-up examinations for cases of ovarian endometrioma. Both had undergone transvaginal ultrasound-guided aspiration of ovarian endometrioma. Because both were continuously febrile and had abdominal pain and cysts with tenderness in spite of antibiotic therapies, both underwent laparotomies for treatment. In both cases, enucleation of the ovarian abscess revealed purulent and malodorous fluid that demonstrated Peptostreptococcus magnus in culture. CONCLUSION: We theorize that following transvaginal ultrasound-guided aspiration of ovarian endometrioma and fixation with pure ethanol, anaerobic infection by P. magnus occurred, and a cyst formed in the abscess. 相似文献
3.
Ultrasound guided aspiration of endometrioma--a new therapeutic modality to improve reproductive outcome. 总被引:2,自引:0,他引:2
S Mittal S Kumar A Kumar A Verma 《International journal of gynaecology and obstetrics》1999,65(1):17-23
OBJECTIVE: To evaluate the therapeutic efficacy and reproductive outcome following ultrasound guided aspiration (UGA) of endometrioma in infertile patients. METHOD: This is a prospective non-randomized clinical report of UGA in 22 infertile patients with endometrioma. The aspiration of endometriotic cysts was carried out transvaginally in nine and transabdominally in 13 patients. Following aspiration intranasal buserilin was given to eight and danazol to 14 patients. In the case of recurrence a reaspiration was done. Patients were allowed to conceive following medical therapy. Recurrence of endometrioma and conception rate was recorded and correlated with endometrioma size and volume aspirated. RESULT: A total of 47 aspirations were done. There were no procedure related complications. Reaspiration was required in six patients and one was operated (total recurrence 7/22--31.8%). During a mean follow-up of 20+/-8.4 months nine patients (40.9%) conceived and eight have already delivered at term. The recurrence risk and the conception rate was not affected by the cyst size or volume aspirated. CONCLUSION: UGA of endometrioma can be an effective and safe alternative therapeutic procedure in infertile patients with endometrioma to improve their reproductive outcome. 相似文献
4.
Agostini A De Lapparent T Collette E Capelle M Cravello L Blanc B 《European journal of obstetrics, gynecology, and reproductive biology》2007,130(1):129-131
OBJECTIVE: Ovarian endometrioma recurrence is frequent. Conventional treatment of ovarian endometrioma is by surgical cystectomy. We proposed an alternative medical treatment for recurrent ovarian endometrioma: cyst aspiration followed by in situ methotrexate injection. STUDY DESIGN: From January 2002 to May 2003, 14 patients with recurrent homolateral ovarian endometrioma underwent transvaginal ultrasound guided cyst puncture and aspiration followed by methotrexate injection, whilst under general anasthesia. Recurrence rate during follow up was evaluated. RESULTS: No complication was reported. After a mean follow up of 20+/-5 month (min: 13, max: 29), four recurrences were diagnosed (28.6%). Two asymptomatic recurrences were not treated and two painful recurrences underwent a second cyst drainage with methotrexate injection. CONCLUSIONS: In situ methotrexate injection is a simple, effective and an interesting alternative to surgical treatment in women with recurrent homolateral ovarian endometrioma. 相似文献
5.
子宫内膜异位症(内异症)是慢性复发性疾病,年复发率约10%。复发性卵巢子宫内膜异位症一般指卵巢子宫内膜异位囊肿复发,是内异症最常见的复发类型,也是导致再次手术的主要原因。治疗原则基本遵循初始治疗,但应个体化。治疗包括药物治疗和手术治疗。常用药物有孕激素类、促性腺激素释放激素激动剂(GnRH-a)、复方口服避孕药物及中医中药等。有些药物比如地诺孕素可以使复发的卵巢子宫内膜异位囊肿明显变小甚至消失,从而免去了患者承受再次手术的风险,近年来广泛推荐使用。再次手术对卵巢储备功能影响更大,术后仍易复发,部分患者也可选择超声引导穿刺治疗。对合并不孕者首先推荐辅助生殖技术。药物维持治疗及长期管理是减少卵巢子宫内膜异位囊肿复发的关键。业已证明,长期使用孕激素类、GnRH-a和复方口服避孕药等均可预防卵巢子宫内膜异位囊肿复发。 相似文献
6.
Ming-Yang Chang Chia-Lin Hsieh Chii-Shinn Shiau T'sang-T'ang Hsieh Rui-Dong Chiang Chien-Hui Chan 《Journal of minimally invasive gynecology》2013,20(5):595-603
Study ObjectiveTo evaluate the efficiency of transvaginal aspiration accompanied by ethanol sclerotherapy for treating cyst recurrence in patients who have previously undergone surgery to treat endometriosis and to analyze various factors that influence success rates using a data mining system.DesignRetrospective cohort study (Canadian Task Force classification II-3).SettingTeaching hospital affiliated with Chang Gung University, Taoyuan, Taiwan.PatientsOne hundred ninety-six patients with endometrioma recurrence.InterventionA total of 274 transvaginal aspirations followed by sclerotherapy with 95% ethanol. Treatment times varied from immediate removal (0–10 minutes) to in situ retention. Patients were followed up at 3, 6, and 12 months to detect complications, determine the size and persistence of cysts, obtain the pelvic pain score, and assess for pregnancy or the need for repeat surgical intervention. A decision tree was used to determine factors from the collected data that most influenced the success of treatment.Measurements and Main ResultsCyst size was consistently reduced until 6 months after ethanol sclerotherapy. The mean (SD) cyst reduction rate was 37.2% (42.2%), and the pain score reduction rate was 20.5% (71.5%). The antral follicle count was simultaneously increased by 36.4%. Sixty-three patients (23%) required repeated surgery during the observation period and were treated with either repeat aspiration (13.5%) or major laparoscopic or open laparotomic interventions (8.4%). Eighteen of 101 infertile patients (17.8%) achieved pregnancy. The total recovery rate (pregnancy or no persistence of symptoms or cyst) was significantly higher in patients in the groups that received longer treatment (7–10 minutes and retention) than in the groups with shorter treatment (0–6 minute) (47.0% vs 28.7%; p < .005). The highest recovery rate was observed in patients with longer treatment time, smaller cysts (≤5.05 cm), lower CA 125 level (≤62.03 IU/mL), and fewer cysts (≤3 cm) (35 of 49 [71.4%]). In patients with larger cysts and cysts with clear contents, better success can be achieved with longer treatment. The use of postoperative ovarian suppression, traditional Chinese medicine, or no therapy for 6 months before the study was not significant among groups.ConclusionUltrasound-guided sclerotherapy with 95% ethanol retention is an effective alternative therapy for recurrent ovarian endometrioma, in particular in selected patient groups. 相似文献
7.
C Yazbeck P Madelenat JP Ayel L Jacquesson LM Bontoux P Solal A Hazout 《Reproductive biomedicine online》2009,18(1):121-125
Several surgical treatment modalities have been described in cases of isolated or multiple ovarian endometriotic cysts. The aim of this preliminary study was to investigate and test the efficacy of ethanol sclerotherapy (EST) for recurrent endometriotic cysts, before ovarian stimulation in infertile patients with an adequate ovarian status. In the setting of a prospective comparative study, EST was proposed to 31 infertile patients with recurrence of ovarian endometriomas before inclusion in assisted reproduction cycles. Reproductive outcome was compared with that of patients who had previous laparoscopic cystectomy for recurrent endometriomas. The mean size of endometriomas treated with sclerotherapy was 38.6 ± 11.2 mm in diameter. Ovarian cysts recurred in 12.9% of cases; at a mean time of 10 months after EST. Ovarian reserve and ovarian response to stimulation were better in the EST group than in the control group. Consequently, clinical and cumulative pregnancy rates of the study group were higher than those of the control group (48.3% versus 19.2%, P = 0.04; and 55.2% versus 26.9%, P = 0.03, respectively). Ethanol sclerotherapy may be a good alternative to surgical management of recurrent endometriotic cysts before assisted reproductive treatment. It could be advised for selected infertile patients. 相似文献
8.
S Lipitz D S Seidman J Menczer D Bider G Oelsner O Moran J Shalev 《The Journal of reproductive medicine》1992,37(10):845-848
The outcome after fluid aspiration from 41 sonographically benign-appearing ovarian cysts was assessed. The considerable probability of recurrence was significantly higher after ultrasound-guided aspiration than following aspiration via laparoscopy (54% versus 30%, respectively, at 36 months). Although all the recurring cysts were benign, the concern with malignancy and the high recurrence rate seem to indicate that fluid aspiration from sonographically benign-appearing cysts by either method is not the management of choice. 相似文献
9.
Lulu Huang Ming-Yang Chang Chii-Shin Shiau T'sang-T'ang Hsieh 《Taiwanese journal of obstetrics & gynecology》2021,60(3):509-512
ObjectiveTo evaluate the effect of transvaginal ultrasound-guided aspiration and ethanol sclerotherapy on anti-müllerian hormone (AMH) in patients with ovarian endometriomas. Setting: Teaching hospital affiliated with Chang Gung University, Taipei.Material and methodsWe retrospectively reviewed 124 patients, with ovarian endometriomas who underwent transvaginal aspiration and sclerotherapy of endometrioma(s) at a tertiary medical center, Chang Gung Memorial Hospital, Taipei, Taiwan. Preoperative evaluation included AMH, midcycle serum CA-125 level, and ultrasonography to exclude possibility of malignancies. Patients underwent ultrasonographic guided transvaginal aspiration and sclerotherapy with 95% ethanol irrigation of the cystic cavity. Patients were grouped into group 1, n = 44, retention of ethanol, and group 2, n = 80, no retention. Serum AMH level was checked at 6 months after aspiration. Those who were infertile prior to therapy were followed up for subsequent pregnancies (either by assisted reproductive technologies, or by natural conception).ResultsThe mean pre-operative AMH levels for the group without retention of ethanol and with ethanol retention were 3.80 and 3.06 respectively (p > 0.05). The change in AMH at 6-month follow up for retained group patients was significantly more than for non-retained group patients, with mean decrease of 0.72 (23.6%) and 0.10 (2.7%) respectively (p < 0.05). 54.5% (retained) and 47.2% (non-retained) of patients failed to achieve pregnancy during the observation period.ConclusionsTransvaginal aspiration of endometriomas followed by sclerotherapy with ethanol can be effective in preserving ovarian reserve, provided that no ethanol is left in situ. 相似文献
10.
目的 探讨左炔诺孕酮宫内缓释系统(LNG-IUS)用于子宫内膜异位症(内异症)患者保守性手术或保守性手术联合药物巩固治疗后复发者治疗的效果.方法 选择因内异症复发而就诊的患者23例,于月经周期第5~7天宫内放置LNG-IUS.所有患者均无生育要求且不愿再次手术.于放置LNG-IUS后3、6、12、24、36个月随访,观察放置LNG-IUS前后患者疼痛视觉模拟(VAS)评分、血清CA125水平、卵巢内异症囊肿体积的变化以及月经情况、体质量等指标.结果 (1)VAS评分:放置LNG-IUS后12个月,痛经、慢性盆腔痛或性交痛缓解最为明显,VAS评分由放置LNG-IUS前的(5.9±2.3)、(4.3±2.0)分下降为(1.0±0.7)、(1.4±1.1)分,分别比较,差异均有统计学意义(P<0.01).(2)囊肿体积:11例患者复发表现为卵巢内异症囊肿,放置LNG-IUS后6个月,卵巢内异症囊肿体积由放置前的(11.4±6.1)cm3下降至(5.5±3.4)cm3,两者比较,差异也有统计学意义(P<0.01);放置12个月时,2例卵巢内异症囊肿消失,放置24个月时,共9例卵巢内异症囊肿消失.(3)血清CA125:从放置LNG-IUS后6个月时开始,CA125水平显著下降,由放置前的(65.5±19.6)kU/L降至放置6个月时的(42.1±13.6)kU/L,差异有统计学意义(P<0.01),放置后12个月时,CA125水平仍继续下降,此后趋于平稳.(4)其他:放置LNG-IUS后6个月内,阴道不规则出血或点滴出血是常见现象,随着放置时间延长,情况明显缓解.少数患者出现体质量增加的情况.结论 内异症保守性手术或手术联合药物巩固治疗后复发的患者,应用LNG-IUS可有效地缓解疼痛症状,降低血清CA125水平,缩小卵巢内异症囊肿体积,是一种有效、安全、持续时间长、全身副作用少、依从性高的治疗方法.Abstract: Objective To evaluate the efficiency of levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment. Methods Twenty-three patients with recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment were treated by LNG-IUS. All patients rejected further operation and had no desire of fertility. The visual analogue scale (VAS) scores of pain, menstrual model, weight and serum CA125 level and the volume of ovarian endometriotic cysts before and after 3, 6, 12, 24 and 36 months of treatment were recorded and compared. Results ( 1 ) VAS score:after 12 months of using LNG-IUS, dysmenorrheal, chronic pelvic pain or dyspareunia were relieved significantly. VAS score were dropped from 5.9 ± 2. 3,4. 3 ± 2.0 to 1.0 ± 0. 7,1.4 ± 1. 1 ( P < 0. 01 ). ( 2 )Volum of cysts :after 6 months of using LNG-IUS, the volume of recurrent ovarian endometriotic cysts in 11 patients were reduced from ( 11.4 ± 6. 1 ) em3 to ( 5. 5 ± 3.4 ) em3 significantly ( P < 0. 01 ). At 12 months of follow-up, it suggested that 2 patients' ovarian endometriotic cysts disappeared. At 24 months follow-up,9 patients ovarian endometriotic cysts disappeared ( 3 ) CA125: serum CA125 decreased from ( 65.5 ± 19. 6 )kU/L to (42. 1 ± 13.6) kU/L at 6 months after treatment remarkably (P < 0. 01 ). Continued to decrease after 12 months and then become steady. Irregular bleeding and spotting was the main side effects, weight gain was also observed in few patients. Conclusions LNG-IUS could be used in treatment of recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment effectively. It could relieve pain, reduce the level of CA125 and decrease the size of ovarian endometriotic cysts. LNG-IUS seems to be an effective, safe, and long term treatment for endometriosis with fewer side effects and better compliance. 相似文献
11.
目的 探讨阴道穿刺后配合口服药物治疗卵巢子宫内膜异位囊肿的临床价值。方法 将61例卵巢子宫内膜异位囊肿穿刺注入无水酒精后分为两组,未服药组19例,服药组42例,其中服丹那唑组22例,服内美通组20例,分别观察其疗效。结果 服药组42例中,3例复发,复发率7.1%,未服药组19例,8例复发,复发率为42.2%,差异有显著性(P<0.05)。结论 阴道穿刺后配合药物治疗卵巢子宫内膜异位囊肿优于单纯囊肿穿刺。本法较适合于合并不孕症的卵巢子宫内膜异位囊肿及曾行内膜异位囊肿剥除术后复发患者。 相似文献
12.
Laparoscopic removal of endometriomas: sonographic evaluation of residual functioning ovarian tissue 总被引:6,自引:0,他引:6
Exacoustos C Zupi E Amadio A Szabolcs B De Vivo B Marconi D Elisabetta Romanini M Arduini D 《American journal of obstetrics and gynecology》2004,191(1):68-72
OBJECTIVE: The aim of this study was to determine whether and to what extent laparoscopic removal of ovarian endometriotic cysts is a tissue-sparing procedure. STUDY DESIGN: At the University Hospital, 77 women of reproductive age with endometriomas and 55 with dermoid cysts underwent laparoscopic removal of the ovarian disease by stripping. Within 1 month before and within 36 months after surgery all patients underwent transvaginal sonographic evaluation of ovarian volume of the endometriomas or dermoid cysts and measurement of the residual ovarian tissue. RESULTS: The residual ovarian volume after surgery was significantly less for the endometrioma group than for the dermoid group. Comparison of the volume of the treated ovary with that of the untreated contralateral ovary showed a significant difference (4.3+/-2.3 cm(3) vs 9.7+/-3.9 cm(3)) only in the endometrioma group. CONCLUSION: Ovarian stripping of endometriomas, but not of ovarian dermoids, is associated with a significant decrease in residual ovarian volume which may result in diminished ovarian reserve and function. 相似文献
13.
P Vercellini N Vendola L Bocciolone A Colombo M T Rognoni G Bolis 《The Journal of reproductive medicine》1992,37(7):577-580
In the period 1988-1990 this prospective study of 33 women with moderate or severe endometriosis who underwent laparoscopy for infertility and/or chronic pelvic pain, was conducted to evaluate the efficacy of aspirating endometriotic cysts followed by administration of a gonadotropin releasing hormone (GnRH) agonist in reducing the size of ovarian endometriomas. The cysts (mean diameter, 4.5 cm; range, 2-7; unilateral, 21 cases; bilateral, 12 cases) were punctured, aspirated, washed and emptied completely. After laparoscopy, 15 subjects received goserelin administered as a 28-day subcutaneous depot for three months, whereas 18 patients undergoing simple observation constituted internal controls. Ultrasound scans were performed before and at one, three and six months after laparoscopy. One case and three controls requested surgery between the four- and five-month follow-up scans and did not complete the study. All the other women had recurrent cysts at the six-month scan. There were no significant differences in mean endometrioma diameter between the two groups at any observation time nor between prelaparoscopic and six-month ultrasound examinations within each treatment group. We conclude that aspiration and washing of endometriotic cysts, combined with postoperative administration of GnRH agonists or not, is ineffective. 相似文献
14.
Endometrioma is one of the most frequent pathologies in gynecologic surgery. Laparoscopic cyst excision is considered the best treatment in terms of lower recurrence and improved fertility. However, it was recently questioned whether the excision of the endometrioma could decrease the function of the operated ovary and if it could affect the subsequent fertility. Even if a consistent amount of ovarian tissue is unintentionally removed together with the capsule of the cyst, resulting in does not show the follicular pattern observed in working ovaries. Currently, no definitive data clarify whether the damage to the ovarian reserve, observed in patient with endometrioma, is related to the surgical procedure, to the previous presence of the cyst, or both. Electrosurgial coagulation during hemostasis could play an important role in terms of damage to ovarian stroma and vascularization. Particular attention must be paid in presence of bilateral endometriotic cysts. In fact, an increase in premature ovarian failure rate was reported when both the ovaries are involved in surgery. Incase of assisted reproductive techniques, no clear evidence indicates which is the best approach for concomitant endometriotic cyst. On the base of these considerations endometriomas Should be treated only in case of pain, infertility, and in asymptomatic patients if the cyst diameter is greater than 4 cm. 相似文献
15.
Luigi Nappi Stefano Angioni Gilda Cinnella Michela Lombardi Pantaleo Greco 《Gynecological endocrinology》2016,32(1):34-37
Operative laparoscopy is the gold standard in the treatment of endometriotic ovarian cysts. Excisional surgery is the best technique to prevent recurrences and improve symptoms but it may result in ovarian reserve damage due to the removal of healthy ovarian cortex. The aim of this study was to assess the impact on ovarian reserve of the use of dual wavelengths laser system (DWLS) hemostasis after stripping technique of monolateral endometrioma, by dosing the anti-Mullerian hormone (AMH). This prospective study was conducted at the Institute of Obstetrics and Gynecology, University of Foggia, from December 2013 to January 2015. Forty-five women underwent excision of monolateral endometriotic ovarian cyst by stripping without using a bipolar coagulation and performing hemostasis with a DWLS. The AMH serum levels were estimated before the surgery (T0), 4–6 weeks (T1) and 6–9 months (T2) after surgery. Our results suggest that an appropriate surgical technique with the use of laser hemostasis does not determine a significant reduction of ovarian reserve. Laser hemostasis could prevent follicular reserve loss after ovarian endometrioma surgery. 相似文献
16.
卵巢子宫内膜异位囊肿的微创性诊断与治疗 总被引:1,自引:0,他引:1
目的探讨B超介导下囊肿穿刺术对卵巢子宫内膜异位囊肿(EMA)的诊断价值和术中囊内注入狄波普维拉(DMPA)维持治疗意义。方法对52例临床诊断为卵巢子宫内膜异位囊肿患者在B超下行囊肿穿刺术,观察囊液性状和并作涂片病理检查,对符合卵巢子宫内膜异位囊肿的患者,腔内注入DMPA,并进行随访。结果经穿刺术校正诊断7例,占13.46%。穿刺术使所有患者近期症状缓解,术中加用DMPA可使症状与体征复发率显著减低。对复发病例可行第二次穿刺术,或再加DMPA治疗仍能有效缓解痛经。DMPA的主要副作用可致阴道点滴状出血及停药后排卵恢复慢,用药组中近期无1例受孕。结论B超引导下的囊肿穿刺术,是对卵巢内膜异位囊肿的一种可行的微创性诊断与治疗方法,DMPA囊腔内给药和术后维持治疗能有效地控制症状和促使异位病灶萎缩。 相似文献
17.
The optimal conservative treatment for endometriotic cysts is unclear, particularly when treated laparoscopically. We performed a systematic analysis of the published literature on ovarian endometrioma especially focused on comparing laparoscopic cystectomy with laparoscopic drainage and coagulation of the cyst with regard to evaluating advantage and disadvantage of each method. We observed that cystectomy was superior in terms of risk of recurrent symptoms, cyst, reoperation, pregnancy: this was true in both prospective and retrospective studies previously published. Given the evidence available, excision of cyst wall in endometrioma is strongly recommended especially in infertile patients. 相似文献
18.
We carried out this clinical study to evaluate the benefits the risks of transvaginal ultrasound-guided aspiration in a group of patients. The study group consisted of 22 premenapausal women who were detected as having benign adnexal cysts, based on ultrasound appearances. Before the procedure, all patients were evaluated thoroughly by pelvic examination, transvaginal ultrasound and serum measurements of CA-125. Oestradiol CA-125, follicle stimulating hormone, luteinising hormone and progesterone were analysed in aspirated cystic fluids as well as cytological evaluation. It was concluded that measurements of follicle stimulating hormone, luteinising hormone, oestradiol and progesterone concentrations in cystic fluid had no prognostic significance. But CA-125 levels over 55 iu/ml were likely to predict the recurrence of the cysts. Cytological examination of the aspirated cystic fluids revealed that 21 cysts were benign functional cysts, but one was serous cystadenoma. We observed recurrence following aspiration in five patients (22.7%) who were followed for 6 months. Patients with simple ovarian cysts will benefit from transvaginal ultrasound-guided aspiration by being saved from surgery and its related complications. However, its use should be limited to those masses that appear to be completely cystic with well-defined borders, because of the risk of the intra-abdominal spillage of the contents of complicated cysts. 相似文献
19.
《Journal of minimally invasive gynecology》2022,29(2):317-323
Study ObjectiveTo investigate the therapeutic efficacy of catheter-directed ethanol sclerotherapy (CDS) and its effect on ovarian reserve in patients with endometrioma at risk of decreased ovarian reserve.DesignRetrospective study.SettingTeaching hospital.PatientsWe evaluated 18 patients with ovarian endometrioma measuring ≥3 cm and preprocedural serum antimüllerian hormone (AMH) levels of <2 ng/mL.InterventionsAn 8.5-F catheter was inserted either transabdominally or transvaginally into the endometrioma. After aspiration, sclerotherapy with 99% ethanol was performed, with a subsequent 20-minute ethanol retention.Measurements and Main ResultsUltrasonography was performed preprocedurally and 6 months after CDS to evaluate any recurrence or changes in cyst size. Furthermore, serum AMH levels, cancer antigen 125 (CA-125) levels, and the visual analog scale scores for dysmenorrhea were obtained to analyze the ovarian reserve and treatment efficacy, preprocedurally and at 6 months after CDS. The mean cyst size on ultrasonography and serum CA-125 levels decreased 6 months after CDS (p <.001 and p = .001, respectively). All patients reported a decreased visual analog scale score for dysmenorrhea (p <.001). However, the difference in serum AMH levels before and after CDS was statistically insignificant (p = .875).ConclusionCDS was efficacious in reducing pain and serum CA-125 levels in patients with low AMH levels without adversely affecting their ovarian reserve. 相似文献
20.
Guariglia L Conte M Are P Rosati P 《European journal of obstetrics, gynecology, and reproductive biology》1999,82(1):5-9
OBJECTIVE: To evaluate the safety and efficacy of ultrasound-guided fine needle aspiration in the treatment of ovarian cysts during pregnancy. STUDY DESIGN: Nine out of twenty-nine patients between the 6th and the 16th week of gestation with unilateral ovarian cysts ranging between 65 and 540 cm3 in volume were selected for sonographically-guided fine needle aspiration. RESULTS: No complications were observed at either short or long-term follow-up; all patients delivered healthy infants at term. Clinical and sonographic post-partum follow-up was uneventful in all cases. In three cases it was necessary to repeat the procedure once and in one case twice during pregnancy. In one case a recurrent serous cyst was excised at operative laparoscopy performed 3 months after delivery. CONCLUSIONS: Ultrasound-guided fine needle aspiration was safely performed in nine patients as an alternative treatment to surgery when persistent monolateral and unilocular ovarian cysts with regular borders and completely anechoic structure are detected during pregnancy. 相似文献