Management of transvaginal ultrasound-guided absolute ethanol sclerotherapy for ovarian endometriotic cysts |
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Authors: | Akiko Ikuta Yoshiaki Tanaka Tomomi Mizokami Akihiro Tsutsumi Masahiro Sato Maki Tanaka Hatsue Kajihara Hideharu Kanzaki |
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Institution: | (1) Department of Obstetrics and Gynecology, Terakata–Ikuno Hospital, Osaka, Japan;(2) Department of Obstetrics and Gynecology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8507, Japan;(3) Department of Internal Medicine, Terakata–Ikuno Hospital, Osaka, Japan;(4) Department of Clinical Laboratory, Terakata–Ikuno Hospital, Osaka, Japan |
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Abstract: | Purpose Endometriosis and endometriotic ovarian cysts are common gynecologic diseases. Excision of the cyst wall by laparotomy or
laparoscopy is the standard treatment for endometriotic ovarian cysts. However, some young patients with cysts would prefer
not to have an abdominal incision. We reviewed and assessed the effectiveness of transvaginal ultrasound-guided ethanol sclerotherapy
in these patients.
Methods Eighteen patients with endometriotic ovarian cysts underwent transvaginal ultrasound-guided aspiration and ethanol sclerotherapy
using spinal anesthesia. The contents of the cysts were drained and sent for cytological examination. The cyst cavities were
washed with absolute ethanol, and the cysts were then filled with absolute ethanol for 5 min. The patients were followed up
with transvaginal ultrasonography.
Results The transvaginal ethanol sclerotherapy was completed in all cases. The mean long diameter of the cysts was 50 mm (31–100 mm),
and the mean operative duration was 22 min (8–45 min). Malignant cells were not isolated from the aspirated fluid in any case.
There were no significant intra- or postoperative complications. Two patients (11.1%) had a recurrence at 3 and 32 months
after ethanol sclerotherapy, respectively.
Conclusions Transvaginal ultrasound-guided absolute ethanol sclerotherapy is useful for ovarian endometriotic cysts, particularly in young
patients or in patients who would like to become pregnant. However, careful selection based on ultrasonography or magnetic
resonance imaging findings and the age of the patients is critical.
The substance of this study was presented in a speech given at the 78th Annual Scientific Meeting of the Japan Society of
Ultrasonics in Medicine in Tokyo, Japan. |
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Keywords: | transvaginal ultrasonography ethanol sclerotherapy ovarian cyst endometriosis |
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