A systematic review of ultrasonography-guided transvaginal aspiration of recurrent ovarian endometrioma

作者：Goncalves Fernanda C; Andres Marina P^*; Passman Leigh J; Goncalves Manoel O C; Podgaec Sergio

来源：International Journal of Gynecology & Obstetrics, 2016, 134(1): 3-7.

DOI：10.1016/j.ijgo.2015.10.021

• Ovarian endometriosis
• Treatment
• Ultrasonography-guided aspiration

Background: Ovarian endometriosis is present in 17%-44% of women with endometriosis. The main treatment is surgery, but ultrasonography-guided aspiration is a less invasive alternative. Objectives: To evaluate the effectiveness of this alternative treatment in recurrent ovarian endometrioma. Search strategy: Multiple databases were searched for articles published between 1994 and 2014 using the keywords "ultrasound-guided aspiration," "ovarian," and "endometriosis." Selection criteria: Randomized controlled trials and observational studies published in English, Portuguese, or Spanish were included. Data collection and analysis: Two researchers independently extracted and reviewed the data. The main outcome of interest was the recurrence rate. Main results: Eight studies were eligible. Ovarian endometriosis is associated with high recurrence rates after one ultrasonography-guided aspiration (28.9%-91.5%), but involves less ovarian manipulation. The results of aspiration followed by sclerotherapy are not uniform, but overall the addition of a sclerosing agent does not seem to significantly reduce the likelihood of recurrence (13.3%-75.0%). Repeated aspiration of the cysts can reduce the recurrence rate to 5.4% by the sixth aspiration. Conclusions: Repeated ultrasonography-guided aspiration of ovarian endometriomas can be performed for the treatment of recurrent ovarian endometriosis. Further studies comparing the efficacy of this procedure and ovarian surgery are needed.

• 出版日期2016-7