Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage under GnRH Analogues and Recombinant Interleukin-2 Left in the Cysts

Pedro Acién, Gloria Pérez-Albert, Francisco J Quereda, Francisco Quereda, Marisa Sánchez-Ferrer, María Luisa Sánchez-Ferrer, Ana García-Almela, Irene Velasco
Gynecologic and obstetric investigation · 2005 · vol. 60(4) , pp. 224–231 · doi:10.1159/000089100 · PMID:16244488 · W2037744185
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Transvaginal ultrasound-guided drainage of endometriomas with intracystic recombinant interleukin-2 under GnRH analogues showed better results and fewer recurrences with two doses compared to one.

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Abstract

BACKGROUND: To analyze the therapeutic results of one dose of 3 million IU of recombinant interleukin-2 (rIL-2) left intracyst (group I) versus two doses with a 1-month interval (group II) after transvaginal ultrasound (US)-guided drainage of endometriomas under the effect of GnRH analogues. METHODS: Prospective and randomized clinical trial (helped by a random number table) at a University Hospital. Twenty-four consecutive patients with endometriomas initially sent to us for laparotomy and conservative surgery for endometriosis were included. INTERVENTIONS: Treatment with GnRH analogues every 28 days, 3 doses. Under their effect, one or two transvaginal US-guided punctures were performed in order to aspirate the endometriomas, and 3 million IU of rIL-2 were left in the aspirated cysts each time. CLINICAL RESULTS: two menstruations after GnRH analogues. Other secondary outcome measures were: the time until recurrence of cysts, symptoms and CA-125 >35 U/ml, and the need for further medical or surgical treatment. RESULTS: They were moderate or good in >50% of cases with one drainage and one dose of 3 million IU of rIL-2 intracyst, but were better with a second drainage and two doses of rIL-2 (25 vs. 58.3% 'good results'). There were fewer recurrences and the interval before recurrence was longer after two doses but differences were not significant. Six patients from group I (50%) and 3 from group II (25%) needed laparotomy and conservative surgery at 17.5 +/- 8.7 months (total time of follow-up = 33 +/- 8.8 months). CONCLUSIONS: Treatment of endometriomas with transvaginal US-guided drainage and rIL-2 left in the cysts under endometrial suppressive therapy with GnRH analogues has beneficial effects, improving clinical manifestations and avoiding some surgical therapies. The use of a higher dose of rIL-2 does not produce better results, whereas drainage + rIL-2 twice does.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Triptorelin Pamoate Administration, Topical Adult Drainage Drainage Endometriosis Endometriosis Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Interleukin-2 Interleukin-2 Interleukin-2 Recombinant Proteins Recombinant Proteins Treatment Outcome

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References (27)

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