Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Clinics (Sao Paulo). 2023 Jun 15;78:100224. doi: 10.1016/j.clinsp.2023.100224. eCollection 2023.
Endometriosis is a chronic inflammatory disease affecting about 10% of women of reproductive age. Endometrioma is the most common presentation of endometriosis in ovaries.
Herein, the authors study the effect of the ultrasound-guided ethanol retention technique for endometrioma sclerotherapy and its effect on the plasma levels of pro-inflammatory cytokines.
Each endometrioma was aspirated and washed with 0.9% saline until clearance and then 2/3 of the cyst volume was filled with ethanol 98%. Patients were followed for 3 months. After that, changes in their cyst diameter, dyspareunia, dysmenorrhea, and antral follicular count were assessed. Also, the sera levels of Interleukin 1β (IL-β), IL-6, and IL-8 were assayed before and after the treatment. The primary sera levels were also compared with a control group.
In the treatment and control groups, 23 and 25 individuals (respectively) with a matched mean age (p-value = 0.680) were enrolled in the study. Among the laboratory variables, IL-1β (p-value = 0.035), as well as AMH (p-value = 0.002), were lower, and IL-6 (p-value = 0.011) was higher in the endometriosis group compared to the controls. Following the treatment, dysmenorrhea, dyspareunia, and the mean diameter of all cysts were significantly (p-values < 0.001) decreased in the treatment group. Also, right (p-value = 0.022) and left (p-value = 0.002) ovaries' antral follicular counts were increased following the treatment. No significant change was found among any of the investigated laboratory levels (p-value > 0.05).
Ethanol retention method is proven to be safe and could improve the clinical status of patients with endometrioma. Although further studies are necessary.
子宫内膜异位症是一种影响约 10%育龄期妇女的慢性炎症性疾病。卵巢子宫内膜异位症是子宫内膜异位症最常见的表现形式。
本研究旨在探讨超声引导下乙醇保留技术治疗子宫内膜异位症囊肿硬化的效果及其对促炎细胞因子血浆水平的影响。
每个子宫内膜异位症囊肿均通过抽吸和用 0.9%生理盐水冲洗至清亮为止，然后将囊肿的 2/3体积填充 98%乙醇。患者随访 3 个月。此后，评估囊肿直径、性交痛、痛经和窦卵泡计数的变化。此外，在治疗前后检测血清白细胞介素 1β（IL-1β）、白细胞介素 6（IL-6）和白细胞介素 8（IL-8）水平。还将原发性血清水平与对照组进行比较。
在治疗组和对照组中，分别有 23 名和 25 名年龄匹配的个体（p 值=0.680）被纳入研究。在实验室变量中，与对照组相比，子宫内膜异位症组的 IL-1β（p 值=0.035）、抗苗勒管激素（AMH）（p 值=0.002）水平较低，IL-6（p 值=0.011）水平较高。治疗后，治疗组的痛经、性交痛和所有囊肿的平均直径均显著降低（p 值均<0.001）。此外，治疗后右侧（p 值=0.022）和左侧（p 值=0.002）卵巢的窦卵泡计数增加。但所有实验室指标均无明显变化（p 值均>0.05）。
乙醇保留法已被证明是安全的，并可改善子宫内膜异位症患者的临床状况。尽管还需要进一步研究。
