tetracycline and Ovarian-Cysts

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.. To evaluate the effectiveness of this alternative treatment in recurrent ovarian endometrioma.. Multiple databases were searched for articles published between 1994 and 2014 using the keywords "ultrasound-guided aspiration," "ovarian," and "endometriosis.". Randomized controlled trials and observational studies published in English, Portuguese, or Spanish were included.. Two researchers independently extracted and reviewed the data. The main outcome of interest was the recurrence rate.. 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.. 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.

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

To investigate the value of tetracycline sclerotherapy for management of recurrent or persisting non-neoplastic ovarian cysts in comparison to the aspiration without sclerotherapy.. Ninety-six patients with proven non-neoplastic ovarian cysts were randomized into two groups. Group 1 patients underwent cyst aspiration together with tetracycline sclerotherapy (n=48). Group 2 patients underwent only cyst aspiration without tetracycline sclerotherapy (n=48). Then, all patients were followed up monthly with ultrasonography for 12months. The procedure was considered to have failed if the recurring cyst, detected by ultrasound, was 4cm in size or greater.. There were no differences between the two groups regarding demographic data, initial cyst volume and tumor markers. Recurrence rates within 12months were 14.6% in group 1 and 50% in group 2 (P<0.001).. Based on the recurrence rates, we suggest transvaginal aspiration together with tetracycline sclerotherapy rather than only simple transvaginal aspiration in the management of non-neoplastic ovarian cysts.

Topics: Anti-Bacterial Agents; Female; Humans; Middle Aged; Ovarian Cysts; Ovary; Recurrence; Sclerotherapy; Suction; Tetracycline; Treatment Outcome; Ultrasonography

Topics: Anti-Bacterial Agents; Female; Humans; Ovarian Cysts; Ovary; Sclerotherapy; Suction; Tetracycline; Ultrasonography

Conventional treatment of endometriosis involves drainage and removal of the cyst wall, which often results in inadvertent resection of normal ovarian tissue. We previously reported that 12 patients were successfully treated with sclerotherapy using 5% tetracycline. We now report our experience with sclerotherapy before in vitro fertilization (IVF) in an additional 20 patients with ovarian endometriomas.. Prospective, cohort.. Private practice.. Women (n = 32) with sonographic evidence of an ovarian endometrioma were offered sclerotherapy in lieu of laparoscopy.. Sclerotherapy was performed under conscious sedation and transvaginal ultrasound guidance. An 18-gauge, single-lumen needle was inserted into the endometrioma, and the cyst contents were sequentially aspirated and flushed with sterile saline until the aspirated fluid was clear. Tetracycline (5%) (5-10 mL) was then instilled into the cyst. Saline was injected into the cul-de-sac to dilute any tetracycline that may have leaked. The fluid was then removed. Ultrasound was performed 6 weeks later to assess the efficacy of treatment.. Resolution of endometrioma and subsequent IVF pregnancy rate.. Complete resolution was observed in 24 (75%) of 32 patients, at follow-up exam. Repeat aspiration of watery fluid was required in eight patients before resolution. Repeat treatment with tetracycline was needed in two patients. Only one patient did not ultimately respond. In vitro fertilization was performed in 28 patients; an ongoing gestation resulted in 16 (57%) from the next cycle.. Sclerotherapy with 5% tetracycline is a simple, effective (and, in our limited series, safe) alternative to surgical intervention for treatment of endometriomas before IVF.

Topics: Adult; Cohort Studies; Endometriosis; Female; Fertilization in Vitro; Humans; Ovarian Cysts; Ovarian Diseases; Pregnancy; Sclerotherapy; Tetracycline; Treatment Outcome; Ultrasonography

Metabolic changes in human spermatozoa related to capacitation were investigated. Glycolysis, motility, oxygen uptake, survival time, and c hanges in tetracycline-binding capacity were studied in spermatozoa expo sed to the following possible capacitating agents: 1) human cervical mucus, 2) human serum, 3) hydroxalpinx fluid, and 4) follicular cyst fluid. Mucus and serum did not produce marked changes. Hydrosalpinx fluid produced an increase in oxygen uptake in the presence of citrate and succinate while follicular cyst fluid produced modifications that could be related to capacitation such as increase in oxygen uptake, increase in motility, and release of bound tetracycline. Similar changes were seen with cyclic adenosine monophosphate and adenosine triphosphate treatment but not with other related nucleotides. The parameters studied in this work are suggestive of functional capacitation.

Topics: Adenosine Triphosphate; Cell Movement; Cervix Mucus; Cyclic AMP; Exudates and Transudates; Female; Glycolysis; Humans; In Vitro Techniques; Male; Ovarian Cysts; Oxygen Consumption; Parovarian Cyst; Sperm Capacitation; Spermatozoa; Stimulation, Chemical; Teratoma; Tetracycline; Tritium