GnRH Analogues, Transvaginal Ultrasound-Guided Drainage and Intracystic Injection of Recombinant Interleukin-2 in the Treatment of Endometriosis

Acién P, Pedro Acién, Francisco J Quereda, Francisco Quereda, María-José Gómez-Torres, María José Gómez‐Torres, Bermejo R, Rosa Barroso Bermejo, Rosa Bermejo, Gutierrez M, Mercedes Gutierrez, Mercedes Gutiérrez
Gynecologic and obstetric investigation · 2003 · vol. 55(2) , pp. 96–104 · doi:10.1159/000070181 · PMID:12771456 · W2064426938
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This study found that transvaginal ultrasound-guided drainage of endometriomas with GnRH analogues, especially when combined with intracystic recombinant interleukin-2, improved clinical symptoms and reduced recurrence rates compared to GnRH analogues alone.

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Abstract

We performed a double-blind, randomised controlled trial to evaluate the results of ultrasound-guided aspiration of endometriomas under the effect of GnRH analogues and a possible additional beneficial effect by leaving 600000 IU of recombinant interleukin-2 (rIL-2) in the cysts. Twenty-four women with endometriosis-related symptoms, increased values of CA-125 and transvaginal ultrasonography showing endometriomas >3 cm who were initially sent to us for laparotomy and conservative surgery for endometriosis were included. Main outcome measures were severity of symptoms, size and percentage of echographical reduction of endometriomas and CA-125 levels after 2 menses post-GnRH analogues. Secondary outcome measures were the time until recurrence of abnormal parameters and the need for surgery after treatment. We found moderate clinical results after treatment with drainage plus GnRH analogues and significantly improved results in women having received rIL-2 intracystically. There were no side effects. Two out of 3 previously infertile patients became pregnant after therapy. Though the rates of recurrence of endometriomas >or=3 cm were similar in both groups, the period until recurrence was significantly greater when rIL-2 was used, and the rates of recurrence of symptoms and increased CA-125 values were also significantly lower in patients who received rIL-2. Surgery was finally performed on 10 patients (4 with and 6 without previous rIL-2 treatment) during follow-up (30 +/- 12.7 months). These findings led to the conclusion that transvaginal ultrasound-guided puncture and aspiration of endometriomas under endometrial suppressive therapy with GnRH analogues have some value for endometriosis treatment, improving the clinical manifestations and avoiding some surgical therapies, and that rIL-2 left in the cyst increases these beneficial effects significantly.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gonadotropin-Releasing Hormone Interleukin-2 Suction Adult Combined Modality Therapy Cysts Cysts Double-Blind Method Endometriosis Female Gonadotropin-Releasing Hormone Humans Interleukin-2 Ovarian Diseases Ovarian Diseases Recombinant Proteins Recombinant Proteins Recurrence Treatment Outcome

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