Ultrasound-guided aspiration with sclerosing therapy in ovarian cyst

Background: Successful treatment of ovarian cyst by aspiration has been reported, especially in cases of simple cyst presumed to be benign. Sotradecol is a mild sclerosing agent used for the treatment of small uncomplicated varicose veins. Aspiration followed by sclerosing therapy with Sotradecol might be a reasonable approach for ovarian cyst in selected cases. Materials and Methods: Samples of 70 cyst fluids were collected for analysis from 62 patients undergoing laparotomy. Estradiol (E₂) and CA-125 levels and cytologic examination results were correlated with the nature of the cyst. Another 51 consecutive patients with unilocular cysts that had been present for over three months were enrolled for this study. The cysts were aspirated and injected with Sotradecol under ultrasound guidance. Results: Only 52% of cyst fluid had adequate cells for cytologic examination. All functional cysts had E₂ levels of over 1,000 pg/mL. CA-125 levels in cyst fluid were not correlated with the nature of the cyst. Ultrasound-guided cyst aspiration with Sotradecol sclerosing therapy resulted in an overall success rate of 78.4%. On reflection, the failure rate could have been reduced to 2%. Conclusion: The examination of cyst aspirate was inadequate for identifying malignancy. Ultrasound-guided aspiration with Sotradecol sclerosing therapy is highly promising for the treatment of selected ovarian cysts.