Ultrasound‐guided aspiration in management of cystic lesions of the ovary

Objective: To evaluate the role of ultrasound‐guided aspiration (UGA) as an alternative therapeutic modality in patients with cystic lesions of ovary (CLO). Methods: Forty‐six patients (age 14–65 years) of CLO were managed by UGA. Patients suspected of having malignancy either clinically or on ultrasound were excluded. The aspiration was done transvaginally (11 patients) or transabdominally (35 patients). All aspirates were subjected to cytological examination. Patients have been followed up for 10–48 months. Results: The cyst size varied from 4 to 30 cm and the volume aspirated ranged from 30 to 1600 ml. There were no procedure‐related complications. No further intervention were required in 33 (71.7%) patients. Re‐aspiration was required in six (13%) and, to date, seven patients (15.3%) have been operated on for recurrence or persistence of lesion. Recurrence rate was not influenced by cyst size or volume aspirated. Mucinous or hemorrhagic aspirate correlated significantly with a higher risk of recurrence. Conclusion: Ultrasound‐guided aspiration is a simple, safe and effective alternative to surgery in management of selected patients with CLO. Simple unilocular cysts can be safely aspirated, but it should not be carried out in patients with multilocular cysts. If the aspirate is hemorrhagic or mucinous, the patient should be considered for surgical intervention.