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Management of transvaginal ultrasound-guided absolute ethanol sclerotherapy for ovarian endometriotic cysts

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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.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Terakata–Ikuno Hospital, Osaka, Japan

    Akiko Ikuta, Yoshiaki Tanaka & Maki Tanaka

  2. Department of Obstetrics and Gynecology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka, 570-8507, Japan

    Akiko Ikuta, Tomomi Mizokami, Akihiro Tsutsumi & Hideharu Kanzaki

  3. Department of Internal Medicine, Terakata–Ikuno Hospital, Osaka, Japan

    Masahiro Sato

  4. Department of Clinical Laboratory, Terakata–Ikuno Hospital, Osaka, Japan

    Hatsue Kajihara

Authors
  1. Akiko Ikuta
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  2. Yoshiaki Tanaka
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  3. Tomomi Mizokami
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  4. Akihiro Tsutsumi
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  5. Masahiro Sato
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  6. Maki Tanaka
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  7. Hatsue Kajihara
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  8. Hideharu Kanzaki
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Corresponding author

Correspondence to Akiko Ikuta.

Additional information

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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Ikuta, A., Tanaka, Y., Mizokami, T. et al. Management of transvaginal ultrasound-guided absolute ethanol sclerotherapy for ovarian endometriotic cysts. J Med Ultrasonics 33, 99–103 (2006). https://doi.org/10.1007/s10396-005-0079-2

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  • DOI: https://doi.org/10.1007/s10396-005-0079-2

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