A mini - invasive technique for diagnosis and treatment of ovarian endometrioma

Objective To assess the feasibility of a mini - invasive technique with ultrasound - guided aspiration of adenexal cysts for diagnosis of ovarian endometrioma and injection of Depot medroxyprogesterone acetate (DMPA) for treatment. Methods 52 cases of adnexal cysts were submitted to transabdominal or transvaginal ultrasound - guided aspiration of the cyst content, and if the aspirated fluid were chocolate like, DMPA or alcohol was injected into the empty cyst. The final diagnosis was made according to the characteristics of the aspirated fluid and cytopathology as well. All cases had been followed up more than 12 months.Results Operations were successful in all cases, and no early complications occurred. Diagnoses were corrected in 7cases (13.46%) .After aspiration the symptom and signs of all the patients was improved recently, but some patients had recurrence within 6 months. The group with DMPA present a better control in symptom of dysmenorrhea and the rate of recurrence was lower than that of the group without DMPA. On the recurrent cases, a second aspiration with or without adding DMPA would still have improvement to relieve symptoms. The main side effects of DMPA were irregular bleeding and spotting, and also a depressing ovulation for a long time. In the process of our study, No one got pregnant in the group of with DMPA. Conclusions Ultrasound - guided aspiration of adnexal cyst is a convenient and minimal invasive technique for the diagnosis and therapy of ovarian endometrioma. It is effective to control symptom and to promote atrophy of ectopic endometrium by giving DMPA simultaneously.