Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (6): 65-69.doi: 10.6040/j.issn.1671-7554.0.2023.0136

• 临床医学 • Previous Articles    

Effects of ultrasound-guided puncture sclerotherapy combined with dienogest in the treatment of ovarian endometriosis cyst

WU Leili1, CAI Huali2, SUN Desheng2, WEI Weixia1   

  1. 1. Obstetrics and Gynecology Center;
    2. Ultrasound Intervention Center, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong, China
  • Published:2023-06-06

PDF (PC)

88

Abstract: Objective To analyze the one-year clinical efficacy of ultrasound-guided puncture sclerotherapy combined with dienogest in the treatment of ovarian endometriotic cyst(OEM)and to explore the impacts on the ovarian reserve function. Methods Clinical data of 20 unmarried OEM patients of childbearing age who underwent ultrasound-guided puncture sclerotherapy combined with dienogest during Jun. 2019 and Dec. 2020 were retrospectively analyzed. The changes in cyst diameter, anti Mullerian hormone(AMH), serum tumor markers CA-125/CA-199 and visual analog scale(VAS)were analyzed. The efficacy and effects on the ovarian reserve function were evaluated with paired t-tests and rank sum tests. Adverse reactions of dienogest were recorded. Results After treatment, the OEM diameter, serum CA-125/CA-199 concentrations and dysmenorrhea VAS score were significantly reduced(P<0.01), while serum AMH level remained unchanged(P>0.01). Irregular vaginal bleeding was the most common complication during long-term dienogest use. A few patients presented with mild weight gain, hair loss, and acnes. No adverse effects on liver and kidney function, coagulation function and mammary gland were observed during follow-up. Conclusion Ultrasound-guided puncture sclerotherapy combined with dienogest can effectively reduce the diameter of cysts in OEM patients, alleviate the menstrual pain and lower serum CA-125/CA-199 levels, with minimal impacts on ovarian reserve function. Dienogest has minimal adverse reactions and can be used for a long-term in the treatment of OEM.

Key words: Ultrasound puncture sclerosis, Dienogest, Ovarian endometrial cyst, Efficacy, Ovarian reserve function

CLC Number: 

  • R711.71
[1] Warzecha D, Szymusik I, Wielgos M, et al. The impact of endometriosis on the quality of life and the incidence of depression-a cohort study [J]. Int J Environ Res Public Health, 2020, 17(10): 3641. doi: 10.3390/ijerph17103641.
[2] 中国医师协会妇产科医师分会, 中华医学会妇产科学分会子宫内膜异位症协作组. 子宫内膜异位症诊治指南(第3版)[J]. 中华妇产科杂志, 2021, 56(12): 812-824.
[3] Becker CM, Bokor A, Heikinheimo O, et al. Eshre guideline: endometriosis [J]. Hum Reprod Open, 2022, 2022(2): hoac9. doi: 10.1093/hropen/hoac009.
[4] Ghiasi M, Kulkarni MT, Missmer SA. Is endometriosis more common and more severe than it was 30 years Ago? [J]. J Minim Invasive Gynecol, 2020, 27(2): 452-461.
[5] Bulun SE, Yilmaz BD, Sison C, et al. Endometriosis [J]. Endocr Rev, 2019, 40(4): 1048-1079.
[6] Kasapoglu I, Ata B, Uyaniklar O, et al. Endometrioma-related reduction in ovarian reserve(error): a prospective longitudinal study [J]. Fertil Steril, 2018, 110(1): 122-127.
[7] Kitajima M, Defrere S, Dolmans MM, et al. Endometriomas as a possible cause of reduced ovarian reserve in women with endometriosis [J]. Fertil Steril, 2011, 96(3): 685-691.
[8] Alborzi S, Zahiri SZ, Askari E, et al. The success of various endometrioma treatments in infertility: a systematic review and meta-analysis of prospective studies [J]. Reprod Med Biol, 2019, 18(4): 312-322.
[9] Singh SS, Suen MW. Surgery for endometriosis: beyond medical therapies [J]. Fertil Steril, 2017, 107(3): 549-554.
[10] 王丹凤, 杨君, 卢深涛. 腹腔镜卵巢子宫内膜异位囊肿剥除术对卵巢储备功能和生育影响的研究进展[J]. 安徽医药, 2023, 27(2): 226-229. WANG Danfeng, YANG Jun, LU Shentao. Research progress on the effect of laparoscopic ovarian endometriosis cystectomy on ovarian reserve function and fertility [J]. Anhui Medical and Pharmaceutical Journal, 2023, 27(2): 226-229.
[11] Ghasemi TH, Tavakoli R, Hashemi M, et al. Ethanol sclerotherapy versus laparoscopic surgery in management of ovarian endometrioma; a randomized clinical trial [J]. Arch Acad Emerg Med, 2022, 10(1): e55. doi: 10.22037/aaem.v10i1.1636.
[12] Nasab S, Bedrick BS, Christianson MS. Ethanol sclerotherapy for endometriomas: ready for prime time? [J]. Fertil Steril, 2021, 115(1): 100-101.
[13] 徐辉雄, 王文平, 胡兵, 等. 卵巢子宫内膜异位囊肿超声引导穿刺硬化治疗专家共识[J]. 中华超声影像学杂志, 2020, 29(12): 1013-1024. XU Huixiong, WANG Wenping, HU Bing. Expert consensus on ultrasound-guided puncture sclerotherapy for ovarian endometriosis cyst [J]. Chinese Journal of Ultrasonography, 2020, 29(12): 1013-1024.
[14] 焦瑞爽, 王国仙, 王品. 超声引导下穿刺介入治疗卵巢囊肿对患者卵巢功能、疗效的影响评价[J]. 影像研究与医学应用, 2018, 2(5): 150-151. JIAO Ruishuang, WANG Guoxian, WANG Pin. Evaluation of the effect of ultrasound-guided puncture intervention on ovarian function and efficacy in patients with ovarian cysts [J]. Journal of Imaging Research and Medical Applications, 2018, 2(5): 150-151.
[15] Kim GH, Kim PH, Shin JH, et al. Ultrasound-guided sclerotherapy for the treatment of ovarian endometrioma: an updated systematic review and meta-analysis [J]. Eur Radiol, 2022, 32(3): 1726-1737.
[16] Crestani A, Merlot B, Dennis T, et al. Impact of laparoscopic sclerotherapy for ovarian endometriomas on ovarian reserve [J]. J Minim Invasive Gynecol, 2023, 30(1): 32-38.
[17] Garcia-Tejedor A, Martinez-Garcia JM, Candas B, et al. Ethanol sclerotherapy versus laparoscopic surgery for endometrioma treatment: a prospective, multicenter, cohort pilot study [J]. J Minim Invasive Gynecol, 2020, 27(5): 1133-1140.
[18] Lee JK, Ahn SH, Kim HI, et al. Therapeutic efficacy of catheter-directed ethanol sclerotherapy and its impact on ovarian reserve in patients with ovarian endometrioma at risk of decreased ovarian reserve: a preliminary study [J]. J Minim Invasive Gynecol, 2022, 29(2): 317-323.
[19] 景文达, 张宇晴, 黄瑛. 乙醇硬化治疗卵巢子宫内膜异位囊肿疗效的影响因素分析[J]. 中国临床医学影像杂志, 2022, 33(10): 724-728. JING Wenda, ZHANG Yuqing, HUANG Ying. Analysis of influencing factors on the efficacy of ethanol sclerotherapy for ovarian endometriotic cysts [J]. Journal of China Clinic Medical Imaging, 2022, 33(10): 724-728.
[20] 黄薇, 冷金花, 裴天骄, 等. 子宫内膜异位症患者生育力保护的中国专家共识(2022版)[J]. 中华妇产科杂志, 2022, 57(10): 733-739. HUANG Wei, LENG Jinhua, PEI Tianjiao, et al. Fertility protection and preservation for patients with endometriosis: a Chinese consensus(2022)[J]. Chinese Journal of Obstetrics and Gynecology, 2022, 57(10): 733-739.
[21] 周应芳. 子宫内膜异位症患者长期管理的必要性[J]. 中华妇产科杂志, 2017, 52(3): 145-146. ZHOU Yingfang. The necessity of long-term management of patients with endometriosis [J]. Chinese Journal of Obstetrics and Gynecology, 2017, 52(3): 145-146.
[22] 黄婷, 黄高廷, 杨国敏, 等. 地诺孕素用于子宫内膜异位症保守术后维持治疗的Meta分析[J]. 国际妇产科学杂志, 2021, 48(1): 26-34. HUANG Ting, HUANG Gaoting, YANG Guomin, et al. Meta analysis of dienogest used in maintenance treatment of endometriosis after conservative surgery [J]. Journal Of International Obstetrics and Gynecology, 2021, 48(1): 26-34.
[23] Muzii L, Galati G, Di Tucci C, et al. Medical treatment of ovarian endometriomas: a prospective evaluation of the effect of dienogest on ovarian reserve, cyst diameter, and associated pain [J]. Gynecol Endocrinol, 2020, 36(1): 81-83.
[24] Romer T. Long-term treatment of endometriosis with dienogest: retrospective analysis of efficacy and safety in clinical practice [J]. Arch Gynecol Obstet, 2018, 298(4): 747-753.
[25] Chen T, Wei JL, Leng T, et al. The diagnostic value of the combination of hemoglobin, ca199, ca125, and he4 in endometriosis [J]. J Clin Lab Anal, 2021, 35(9): e23947. doi: 10.1002/jcla.23947.
[26] Yoshino O, Minamisaka T, Ono Y, et al. Three cases of clear-cell adenocarcinoma arising from endometrioma during hormonal treatments [J]. J Obstet Gynaecol Res, 2018, 44(9): 1850-1858.
[1] SHAO Changxiu, HE Qingqing, ZHANG Xiaoxuan, ZHOU Peng, LI Xiaolei, YUE Tao, XU Jing, LI Chenyu, GUO Haonan, ZHUANG Dayong. Long-term efficacy of total parathyroidectomy with trace parathyroid tissue autotransplantation in the treatment of 109 cases of renal secondary hyperparathyroidism [J]. Journal of Shandong University (Health Sciences), 2023, 61(4): 42-48.
[2] YANG Xiaofei, HAN Bo, JIANG Diandong, LYU Jianli,YI Yingchun, ZHANG Jianjun, ZHAO Lijian, WANG Jing, WANG Yan, YUAN Hui. A clinical analysis of radiofrequency catheter ablation of tachyarrhythmia in 972 children in a single center [J]. Journal of Shandong University (Health Sciences), 2023, 61(2): 49-56.
[3] JU Yanli, WANG Lihua, CHENG Fang, HUANG Fengyan, CHEN Xueyu, JIA Hongying. Construction of predictive models of radioiodine therapy based on machine learning [J]. Journal of Shandong University (Health Sciences), 2023, 61(1): 94-99.
[4] MIAO Zhuang, LIU Peilai, LU Qunshan, YAO Tianxiao, LI Songlin, LUO Desu. Early efficacy of double-column mobile bearing unicompartmental knee prosthesis in treating medial knee osteoarthritis [J]. Journal of Shandong University (Health Sciences), 2021, 59(5): 90-95.
[5] LUO Yingshu, LI Bin, XU Changqin, JIANG Junmei, XU Hongwei. Evaluation of the efficacy and complications of endoscopic treatment of 240 cases of upper gastrointestinal submucosal tumors [J]. Journal of Shandong University (Health Sciences), 2021, 59(3): 74-80.
[6] LIN Yuxi, LI Chuanxi, WANG Lin, MA Wei. Sexual orientation disclosure and HIV testing uptake among men who have sex with men: chain mediating effect of HIV testing social norms and self-efficacy [J]. Journal of Shandong University (Health Sciences), 2021, 59(3): 113-119.
[7] LU Cuiyan, PAN Fang, FANG Fang. Relationship between active or passive procrastination and mindfulness, and self-efficacy of college students [J]. Journal of Shandong University (Health Sciences), 2021, 59(10): 110-115.
[8] JIA Jianhua, CHEN Si, WU Qianqian, XU Shuo, LI Chao, CHENG Lian, XU Shujun. Efficacy of SEEG-guided radiofrequency thermocoagulation in patients with medically intractable epilepsy [J]. Journal of Shandong University (Health Sciences), 2021, 59(10): 82-88.
[9] XIAO Juan, XIAO Qiang, CONG Wei, LI Ting, DING Shouluan, ZHANG Yuan, SHAO Chunchun, WU Mei, LIU Jianing, JIA Hongying. Comparison of diagnostic efficacy of two kinds of thyroid imagine reporting and data systems [J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 53-59.
[10] JING Xiang, WANG Yali, LU Lu, XIA Yu, JIAO Anan, LI Yaozu, XU Lingzhong. Relationship among activity of daily life, social support and loneliness in rural elderly: mediating effects of general self-efficacy [J]. Journal of Shandong University (Health Sciences), 2020, 58(1): 94-99.
[11] ZHANG Guoying, WANG Jing, WANG Chuanxia, ZHANG Xuan, CHI Xiangyu, LI Qing. Efficacy of high flow nasal cannulae therapy for acute cardiogenic pulmonary edema [J]. Journal of Shandong University (Health Sciences), 2020, 58(1): 77-80.
[12] GENG Xu, ZHANG Lu, LI Ming, LU Zhiming. Application value of combined detection of tumor-associated autoantibodies in the diagnosis of colorectal cancer [J]. Journal of Shandong University (Health Sciences), 2019, 57(4): 65-71.
[13] PAN Yanyan, SUN Yongchao, LIU Xuemei, ZHANG Hongxia, ZHOU Weiran, ZHAO Cuifen. Correlation between urinary α1-antitrypsin and transferrin levels and hormone therapy effect on childrens primary nephrotic syndrome [J]. Journal of Shandong University (Health Sciences), 2019, 57(12): 74-79.
[14] YAO Xudong. Strategy and efficacy of surgical treatment in locally advanced prostate cancer [J]. Journal of Shandong University (Health Sciences), 2019, 57(1): 21-25.
[15] WEI Mingyong, REN Huiling, WU Jun, PENG Xue, XIE Wenfu, ZHANG Min. Clinical efficacy of endoscopic resection of small colorectal polyps with thermal biopsy forceps [J]. Journal of Shandong University (Health Sciences), 2018, 56(6): 47-50.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd