Efficacy of Sclerotherapy for Management of Recurrent Benign Adnexal Cys

Abstract

Objective: To evaluate the applicability and efficacy of the sclerotherapy for management of pseudocysts and recurrent benign ovarian cysts. Material and Method: From February 1997 to August 1997, six patients with suspected pseudocyst and fifteen patients with suspected benign recurrent adnexal cyst (12 cases of endometrioma: 2 cases of serous cystadenoma: 1 case of paraovarian cyst) who had undergone previous pelvic surgery were included in this prospective study. All patients underwent pelvic color doppler sonography (CDS) and their blood sampled for the tumor makers α-FP, CEA, β-hCG, CA-125. The patients without suspicion of malignany were scheduled for sclerotherapy. Under intravenous analgesia, the cysts were irrigated with dehydrated alcohol of 2/3 volumn first and then with 5% doxycycline of 10% volume was inserted after complete cyst aspiration under the transvaginal ultrasonogram. The aspirated contents were sent for cytologic examination. All the patients were followed up monthly with CDS for over 4 months. Results: All cysts revealed to be benign upon cytologic examination, were 4cm-15cm in size, and 25cc-820cc in aspirated volume. In two patients with serous cystadenoma confirmed by cytology, pelviscopic surgery were performed. In thirteen patients with benign recurrent adnexal cyst, there was excellent ovarian parenchymal preservation and no recurrances with this procedure after follow-up for 4-10 months. But in the two patients with pseudocysts, the cysts recurred after repetitive attempts and sustained for 4-6 months with reduction of size and symptom. Conclusion: Sclerotherapy is an easy, safe and highly effective procedure and considered as valid alternative method for management of benign recurrent adnexal cyst, although for pseudocysts the efficacy was not conclusive. But considering the limitation of ultrasonography and tumor markers in determining malignancy of tumor, this procedure has to be confined to patients with the benign recurrent cyst confirmed by previouslyoperative procedures.