The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts

Abstract

Mehmet Şimşek,1 Tuncay Kuloğlu,2 Şehmus Pala,3 Abdullah Boztosun,4 Behzat Can,1 Remzi Atilgan1 1Department of Obstetrics and Gynecology, 2Department of Histology, Firat University School of Medicine, Elazig, Turkey; 3Clinic of Obstetrics and Gynecology, Batman Yasam Hospital, Batman, Turkey; 4Department of Obstetrics and Gynecology, Akdeniz University School of Medicine, Antalya, Turkey Objectives: To examine the effect of 95% ethanol sclerotherapy (EST) administered over 5 minutes on cyst diameter and ovarian tissue in experimentally induced simple ovarian cysts in a rat model. Materials and methods: In order to induce ovarian cysts, unilateral total salpingectomy was performed in regularly menstruating adult female Wistar albino rats (n=20) between 12 and 14 weeks of age and weighing between 200 and 220 g. One month after the procedure, the abdominal cavity was opened and 14 rats (70%) were found to have developed macroscopic cysts. Rats with macroscopic cysts (n=14) were assigned into two groups in a prospective and single-blinded manner: group 1 (G1) (n=7), control rats; and group 2 (G2) (n=7), 5-minute EST 95% group. Cyst diameter was measured and recorded for each rat. In G2, after whole cyst fluid was aspirated the cystic cavity was irrigated with 95% ethanol, approximately equal to half of the aspirated cyst volume, after which an interval of 5 minutes was allowed and same amount was re-aspirated and the abdominal cavity was closed. One month after this procedure, abdominal cavities were reopened and intra-abdominal adhesion scoring was performed in both groups. Cyst diameter was measured for each rat, and the right ovary was removed, fixed in 10% formaldehyde, and transported to the laboratory. A histologic assessment of the ovarian tissues was performed under light microscopy following staining with hematoxylin and eosin. Mann–Whitney U-test was used for statistical analysis. A P-level less than 0.05 was considered significant. Results: In comparison with G1, there was a statistically significant reduction in the mean ovarian cyst dimensions in G2, while there were no significant differences between the two groups with respect to total number of follicles. Again, a significant increase in apoptotic activity and germinal epithelial degeneration was observed in G2 as compared to G1. The two groups were similar in terms of adhesion formation. Conclusion: Although 95% EST results in a reduction in the size of simple ovarian cysts, this effect seems to be achieved at the expense of ovarian tissue injury. Keywords: ethanol instillation, salpingectomy, ovarian morphology, simple ovarian cyst, adhesion