Ultrasound guided aspiration in pathological adnexal processes

Objective: To establish the efficiency of ultrasonographically guided transvaginal adnexal cyst aspiration as a treatment and diagnostic method. Study Design: In 72 patients with an adnexal cystic mass, transvaginal ultrasound guided cyst aspiration was performed. Before the procedure, presence of primary malignant disease was excluded by gynecologic and ultrasound examination. Cyst content was sent for cytological analysis. Cytological findings were staged according to Papanicolaou. Patients were re-examined 3 and 6 months after the ultrasound intervention. Cysts measuring 3 cm or more in diameter were considered to be recurrence of the disease. Results: Recurrence of the disease appeared in 32 cases (44%) and was more common with larger cysts. Malignant cells were found in one case (1.5%), a recurrent ovarian cancer, previously treated by surgery and chemotherapy. Conclusion: In our study, ultrasound guided aspiration of adnexal cysts was not shown to be an efficient method of treatment because of the high recurrence rate. It may be used in selected patients at high anaesthesiologic risk for surgery as a therapeutic or a diagnostic procedure.