Investigation of treatment efficacy of 10% povidone–iodine sclerotherapy on ovarian cyst diameter: an experimental study
Investigation of treatment efficacy of 10% povidone–iodine sclerotherapy on ovarian cyst diameter: an experimental study
Background/aim: The purpose of this study was to investigate the effects of 10% povidone–iodine (PI) sclerotherapy on ovarian cystdiameter through an experimental study.Materials and methods: To be able to create ovarian cysts, right unilateral salpingectomy was performed on 20 Wistar albino rats. Onemonth after the operation, the abdomens of all rats were reopened. Sixteen rats with macroscopic ovarian cysts were divided randomlyinto 2 groups consisting of 8 rats. Group 1 (G1): the cyst content was only aspirated. Group 2 (G2): the ovarian cyst was aspirated andthen the cystic cavity was irrigated with PI. Abdomens of all rats were closed and 1 month later they were reopened. Tissues of the rightovaries of the rats were embedded in paraffin blocks for histopathological examination. Follicle count, fibrosis, and congestion wereevaluated under a light microscope.Results: For G1, there was no difference in cyst diameters before and after aspiration. In G2, a decrease was observed in cyst diameter.There was no difference in ovarian reserve between the 2 groups. When compared with G1, an increase in fibrosis and congestion wasdetermined in G2.Conclusions: Sclerotherapy into the ovarian cyst for a 5-min period using 10% PI reduces cyst diameter without any change in ovarianreserve.
___
- 1. van Nagell JR Jr, Miiler RW. Evaluation and management of
ultrasonographically detected ovarian tumors in asymptomatic
women. Obstet Gynecol 2016; 127: 848-858.
- 2. Glanc P, Benacerraf B, Bourne T, Brown D, Coleman BG, Crum
C, Dodge J, Levine D, Pavlik E, Timmerman D et al. First
international consensus report on adnexal masses: management
recommendations. J Ultrasound Med 2017; 36: 849-863.
- 3. Royal College of Obstetricians and Gynaecologists.
Management of suspected ovarian masses in premenopausal
women. Green-top Guideline 2011; 62: 1-14.
- 4. Hasson HM. Laparoscopic management of ovarian cysts.
Journal of Reproductive Medicine 1990; 35: 863-867.
- 5. Balat O, Sarac K, Sonmez S. Ultrasound guided aspiration of
benign ovarian cysts: an alternative to surgery? European
Journal of Radiology 1996; 22: 136-137.
- 6. Benagiano G, Petraglia F, Gordts S, Brosens I. A new approach
to the management of ovarian endometrioma to prevent tissue
damage and recurrence. Reprod Biomed Online 2016; 32: 556-
562.
- 7. Wang LL, Dong XQ, Shao XH, Wang SM. Ultrasound-guided
interventional therapy for recurrent ovarian chocolate cysts.
Ultrasound Med Biol 2011; 37: 1596-1602.
- 8. Nikolaou M, Adonakis G, Zyli P, Androutsopoulos G,
Saltamavros A, Psachoulia C, Tsapanos V, Decavalas G.
Transvaginal ultrasound-guided aspiration of benign ovarian
cysts. J Obstet Gynaecol 2014; 31: 1-4.
- 9. Okagaki R, Osuga Y, Momoeda M, Tsutsumi O, Taketani Y.
Laparoscopic findings after ultrasound-guided transvaginal
ethanol sclerotherapy for ovarian endometrial cyst. Hum
Reprod 1999; 14: 270.
- 10. Chang MY, Hsieh CL, Shiau CS, Hsieh TT, Chiang RD, Chan
CH. Ultrasound-guided aspiration and ethanol sclerotherapy
(EST) for treatment of cyst recurrence in patients after previous
endometriosis surgery: analysis of influencing factors using a
decision tree. J Minim Invasive Gynecol 2013; 20: 595-603.
- 11. Gupta P, Huria A. Management of ovarian cysts with
percutaneous aspiration and methotrexate injection. Niger
Med J 2016; 57: 19-23.
- 12. Fisch JD, Sher G. Sclerotherapy with 5% tetracycline is a simple
alternative to potentially complex surgical treatment of ovarian
endometriomas before in vitro fertilization. Fertil Steril 2004;
82: 437-441.
- 13. Koike T, Minakami H, Motoyama M, Ogawa S, Fujiwara H,
Sato I. Reproductive performance after ultrasound-guided
transvaginal ethanol sclerotherapy for ovarian endometriotic
cysts. Eur J Obstet Gynecol Reprod Biol 2002; 105: 39-43.
- 14. Shrestha A, Shrestha PM, Verma R. Is single dose povidone
iodine sclerotherapy effective in chyluria? Int Urol Nephrol
2014; 46: 1059-1062.
- 15. Lachapelle JM. A comparison of the irritant and allergenic
properties of antiseptics. Eur J Dermatol 2014; 24: 3-9.
- 16. Vermeulen H, Westerbos SJ, Ubbink D. Benefit and harm of
iodine in wound care: a systematic review. J Hosp Infect 2010;
76: 191-199.
- 17. Opitz I, Sigrist B, Hillinger S, Lardinois D, Stahel R, Weder
W, Hopkins-Donaldson S. Taurolidine and povidone–iodine
induce different types of cell death in malignant pleural
mesothelioma. Lung Cancer 2007; 56: 327-336.
- 18. El Harrech Y, Sossa J, Chafiki J, Janane A, Ameur A, Abbar
M. Role of polyvidone–iodine ablation in the management of
symptomatic renal cysts. J Radiol 2009; 90: 1075-1078.
- 19. Lim HK, Cho JY, Kim SH. Sclerotherapy of peritoneal
inclusion cysts: a long-term evaluation study. Abdom Imaging
2010; 35: 431-436.
- 20. Atilgan R, Ozkan ZS, Kuloglu T, Kocaman N, Baspinar M,
Can B, Şimşek M, Sapmaz E. Impact of intracystic ethanol
instillation on ovarian cyst diameter and adjacent ovarian
tissue. Eur J Obstet Gynecol Reprod Biol 2014; 174: 133-136.
- 21. Mazaud S, Guigon CJ, Lozach A, Coudouel N, Forest MG,
Coffigny H, Magre S. Establishment of the reproductive
function and transient fertility of female rats lacking primordial
follicle stock after fetal gamma-irradiation. Endocrinology
2002; 143: 4775-4787.
- 22. Koutlaki N, Nikas I, Dimitraki M, Grapsas X, Psillaki A,
Mandratzi J, Liberis A, Liberis V. Transvaginal aspiration of
ovarian cysts: our experience over 121 cases. Minim Invasive
Ther Allied Technol 2011; 20: 155-159.
- 23. Castellarnau Visus M, Ponce Sebastia J, Carreras Collado R,
Cayuela Font E, Garcia Tejedor A. Preliminary results: ethanol
sclerotherapy after ultrasound-guided fine needle aspiration
without anesthesia in the management of simple ovarian cysts.
J Minim Invasive Gynecol 2015; 22: 475-482.
- 24. Kars B, Buyukbayrak EE, Karsidag AY, Pirimoglu M, Unal
O, Turan C. Comparison of success rates of ‘transvaginal
aspiration and tetracycline sclerotherapy’ versus ‘only
aspiration’ in the management of non-neoplastic ovarian cysts.
J Obstet Gynaecol Res 2012; 38: 65-69.
- 25. Zanetta G, Lissoni A, Dalla Valle C, Trio D, Pittelli M, Rangoni
G. Ultrasound-guided aspiration of endometriomas: possible
applications and limitations. Fertil Steril 1995; 64: 709-713.
- 26. Cohan RH, Saeed M, Schwab SJ, Perlmutt LM, Dunnick NR.
Povidone–iodine sclerosis of pelvic lymphoceles: A prospective
study. Urol Radiol 1988; 10: 203-206.
- 27. Benz RL, Schleifer CR. Hydrothorax in continuous ambulatory
peritoneal dialysis: Successful treatment with intrapleural
tetracycline and a review of the literature. Am J Kidney Dis
1985; 2: 136-140.
- 28. Bakhytzhan S, Mukhtar S, Ruslan K, Denis V, Gulziya I. Singlecenter experience in the surgical treatment of combined lung
Echinococcosis. Saudi Med J 2018; 39: 31-37.
- 29. Teruel JL, Escobar EM, Quereda C, Mayayo T, Ortuno JC. A
simple and safe method for management of lymphocele after
renal transplantation. J Urol 1983; 130: 1058-1059.
- 30. Damiano G, Lombardo C, Palumbo VD, Buffa D, Maione C,
Gioviale MC, Cacciabaudo F, Spinelli G, Calvagna C, Lo Monte
AI. A simple method to treat post-kidney transplantation
lymphocele. G Chir 2011; 32: 73-76.
- 31. Şimşek M, Kuloğlu T, Pala Ş, Boztosun A, Can B, Atilgan R.
The effect of ethanol sclerotherapy of 5 minutes duration on
cyst diameter and rat ovarian tissue in simple ovarian cysts.
Drug Des Devel Ther 2015; 9: 1341-1347.
- 32. Madeb R, Feldman PA, Knopf J, Rub R, Erturk E, Yachida D.
Povidone–iodine sclerotherapy is ineffective in the treatment
of symptomatic renal cysts. J Endourol 2006; 20: 402-404.
- 33. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A
systematic review of tests predicting ovarian reserve and IVF
outcome. Hum Reprod Update 2006; 12: 685-718.
- 34. Var T, Batioglu S, Tonguc E, Kahyaoglu I. The effect of
laparoscopic ovarian cystectomy versus coagulation in bilateral
endometriomas on ovarian reserve as determined by antral
follicle count and ovarian volume: a prospective randomized
study. Fertil Steril 2011; 95: 2247-2250.
- 35. Lee KH, Kim CH, Lee YJ, Kim SH, Chae HD, Kang BM.
Surgical resection or aspiration with ethanol sclerotherapy of
endometrioma before in vitro fertilization in infertile women
with endometrioma. Obstet Gynecol Sci 2014; 57: 297-303.
- 36. Han K, Seo SK, Kim MD, Kim GM, Kwon JH, Kim HJ, Won
JY, Lee DY. Catheter-directed sclerotherapy for ovarian
endometrioma: short-term outcomes. Radiology 2018; 289:
854-859.
- 37. Artaş G, Pala Ş, Kuloğlu T, Atilgan R, Yavuzkir Ş, Akyol A. The
effects of sclerotherapy with 5% trichloroacetic acid on the cyst
diameter and ovarian tissue in the rat ovarian cyst model. J
Obstet Gynaecol 2018; 38: 686-692.
- 38. Souza AZ, Fonseca AM, Izzo VM, Clauzet RM, Salvatore
CA. Ovarian histology and function after total abdominal
hysterectomy. Obstet Gynecol 1986; 68: 847-849.
- 39. Cheong SH, Yang YI, Choi MY, Kim MH, Cho KR, Lim SH, Lee
JH, Lee KM, Moon SH. Lung injury induced by the pulmonary
instillation of povidone–iodine in rats. J Anesth 2012; 26: 70-
79.