Document Detail


Treatment of endometriosis with transvaginal ultrasound-guided drainage under GnRH analogues and recombinant interleukin-2 left in the cysts.
MedLine Citation:
PMID:  16244488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To analyze the therapeutic results of one dose of 3 million IU of recombinant interleukin-2 (rIL-2) left intracyst (group I) versus two doses with a 1-month interval (group II) after transvaginal ultrasound (US)-guided drainage of endometriomas under the effect of GnRH analogues. METHODS: Prospective and randomized clinical trial (helped by a random number table) at a University Hospital. Twenty-four consecutive patients with endometriomas initially sent to us for laparotomy and conservative surgery for endometriosis were included. INTERVENTIONS: Treatment with GnRH analogues every 28 days, 3 doses. Under their effect, one or two transvaginal US-guided punctures were performed in order to aspirate the endometriomas, and 3 million IU of rIL-2 were left in the aspirated cysts each time. MAIN OUTCOME MEASURES: Clinical results: two menstruations after GnRH analogues. Other secondary outcome measures were: the time until recurrence of cysts, symptoms and CA-125 >35 U/ml, and the need for further medical or surgical treatment. RESULTS: They were moderate or good in >50% of cases with one drainage and one dose of 3 million IU of rIL-2 intracyst, but were better with a second drainage and two doses of rIL-2 (25 vs. 58.3% 'good results'). There were fewer recurrences and the interval before recurrence was longer after two doses but differences were not significant. Six patients from group I (50%) and 3 from group II (25%) needed laparotomy and conservative surgery at 17.5 +/- 8.7 months (total time of follow-up = 33 +/- 8.8 months). CONCLUSIONS: Treatment of endometriomas with transvaginal US-guided drainage and rIL-2 left in the cysts under endometrial suppressive therapy with GnRH analogues has beneficial effects, improving clinical manifestations and avoiding some surgical therapies. The use of a higher dose of rIL-2 does not produce better results, whereas drainage + rIL-2 twice does.
Authors:
Pedro Acién; Gloria Pérez-Albert; Francisco J Quereda; Marisa Sánchez-Ferrer; Ana García-Almela; Irene Velasco
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-10-21
Journal Detail:
Title:  Gynecologic and obstetric investigation     Volume:  60     ISSN:  0378-7346     ISO Abbreviation:  Gynecol. Obstet. Invest.     Publication Date:  2005  
Date Detail:
Created Date:  2005-10-31     Completed Date:  2006-01-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7900587     Medline TA:  Gynecol Obstet Invest     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  224-31     Citation Subset:  IM    
Copyright Information:
Copyright 2005 S. Karger AG, Basel.
Affiliation:
Service of Obstetrics and Gynecology, San Juan University Hospital and Department of Gynecology, School of Medicine, Miguel Hernandez University, Campus of San Juan, Alicante, Spain. acien@umh.es
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adult
Drainage / methods
Endometriosis / drug therapy,  pathology,  therapy*,  ultrasonography
Female
Gonadotropin-Releasing Hormone / agonists
Humans
Interleukin-2 / administration & dosage,  therapeutic use
Recombinant Proteins / therapeutic use
Treatment Outcome
Triptorelin / therapeutic use*
Chemical
Reg. No./Substance:
0/Interleukin-2; 0/Recombinant Proteins; 33515-09-2/Gonadotropin-Releasing Hormone; 57773-63-4/Triptorelin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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