Abstract: Objectives: To evaluate the therapeutic yield of aspiration and sclerotherapy of simple ovarian cyst or
endometrioma, using tetracycline or ethanol 95%. Patients & Methods: The study included 120 multigravida
multipara women with average age of 30±4.6 years old. women were randomly allocated into 3 equal groups
included (Group A ) : Aspiration group assigned to undergo transvaginal ultrasonography guided cyst aspiration
without sclerotherapy, (Group T ) Tetracycline group assigned to undergo cyst aspiration and instillation of
tetracycline 5% solution (5-10 ml) and (Group E ) Ethanol group assigned to undergo cyst aspiration and instillation
of ethanol 95% in a volume equal to the volume aspirated out of the cyst. Patients were assessed after 3 months for
cyst resolution and at 6th and 12th postoperative (PO) months for recurrence; the cyst was considered recurrent if it
>4cm in diameter. Results: the results indicated that 49 women (40.8%) had simple serous cyst and 71 women
(59.2%) had endometrioma. All procedures were conducted uneventfully as one-day procedure. At the end of the 3rd
PO month, all cysts showed significant diminution of diameter compared to preoperative diameter. At the 6th PO
month, 17 women had recurrent cysts and at the 12th PO month, another 20 patients had recurrent cysts.
Collectively, there were 13 recurrent serous cysts and 24 recurrent endometrioma. Aspiration only showed a
significantly higher recurrence rate (55%) compared to aspiration and instillation (18.8%), irrespective of the
sclerosant used. Moreover, Group A showed significantly higher recurrence rate compared to Group T and Group E,
20% and 17.5%, respectively with non-significantly higher recurrence rate with tetracycline than with ethanol.
Morever recurrence rate of endometrioma was significantly higher in Group A compared to Group T and Group E
with non-significantly higher recurrence rate of endometrioma in Group T compared to Group E. Conclusion:
Aspiration and sclerotherapy of ovarian cyst is a safe and effective treatment with a significantly low recurrence rate
compared to simple aspiration only. The non-significant difference between the outcome of tetracycline and ethanol
sclerotherapy allowed the choice to depend on the surgeon’s preference. |
