Preliminary Results: Ethanol Sclerotherapy After Ultrasound-Guided Fine Needle Aspiration Without Anesthesia in the Management of Simple Ovarian Cysts

Study Objective: To investigate the feasibility of ultrasound-guided, fine-needle aspiration and ethanol sclerotherapy of simple ovarian cysts in an office setting without anesthesia. We also describe the rate of cyst recurrence in patients treated with this technique and explore the associated risk factors. Design: Prospective follow-up of patients after ethanol sclerotherapy of simple adnexal cysts in a single center trial (Canadian Task Force classification II-1). Setting: The study was conducted at Bellvitge Teaching Hospital in Barcelona, Spain. Patients: Ethanol sclerotherapy was performed on 60 simple adnexal cysts between 2009 and 2012. Interventions: Ultrasound-guided fine-needle aspiration and ethanol sclerotherapy. Measurements and Main Results: Patient demographics and cyst characteristics were collected for all patients. Potential risk factors for recurrence were analyzed by univariate and multivariate analyses. All the procedures, except 1, were performed without anesthesia. The only major complication was a case of self-limiting hem peritoneum that was managed expectantly. Moderate abdominal pain occurred in 26.7% of patients during the procedure. Fifty-five patients completed at least 6 months of follow-up and were included in the statistical recurrence analyses. Cyst recurrence was recorded in 9.1% of the patients and was managed in the usual manner in all the cases. Univariate analyses indicated that a larger cyst diameter and a higher estimated cyst volume were significantly associated with recurrence. In the multivariate analysis, recurrence was only significantly associated with estimated cyst volume. Conclusion: Ethanol sclerotherapy of simple ovarian cysts in an office setting without anesthesia is a feasible technique associated with a low rate of complications and recurrence, although larger randomized studies are necessary to assess the predictive factors for cyst recurrence. (C) 2015 AAGL. All rights reserved.