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

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This review evaluated ultrasonography-guided transvaginal aspiration for recurrent ovarian endometrioma, finding high recurrence rates after a single aspiration but a reduction with repeated aspirations.

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Abstract

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.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Ovarian Cysts Sclerotherapy Ultrasonography, Interventional Endometriosis Ethanol Ethanol Female Humans Methotrexate Methotrexate Observational Studies as Topic Ovarian Cysts Randomized Controlled Trials as Topic Recurrence Tetracycline Tetracycline

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (33)

Cited by (17)

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europepmc
last seen: 2026-07-04T06:08:07.471253+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:21:07.355239+00:00
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