Alcohol sclerosing ovarian cystic lesions, 20 years experience

The purpose of the study is to present technique of punction and conservative treatment of cystic ovarian lesions. The following criteria were included: 1) Cyst should be unilocular, sonolucent, with a smooth inner wall of capsule, without septa and without neovasculariation on transvaginal color and power Doppler. 2) Serum CA-125 levels must be lower than 35 U/mL. The capsule of the cyst was punctured with a 18 gauge needle under the control of 5 MHz transvaginal probe. Cyst fluid was sent for cytologic examination. After complete emptying of the cyst, we injected sterile 95% ethanol in the 50-75% of the evacuated liquor amount. The alcohol remain in the cyst from 5 to 20 minutes and was then aspirated completely. We punctured cysts in 366 patients aged from 18 to 65 years, volume of cyst being between 40 and 300 mL. Patients were monitored for 24 hours and follow-up examinations were 3, 6 and 12 months after the procedure. Three cysts were ruptured (0.8%) and alcohol split in the Douglas cavity. Intensive pelvic pain had 8.1% and relapse appeared in 8.2% of the patients. Technique ofpunction is simple and easily performed. Method of treating by 95% alcohol has demonstrated good results. Relapse we treated by laparoscopy or laparotomy.