Minimally invasive surgical management of symptomatic uterine cysts

Abstract

This study aims to evaluate the feasibility of a minimally invasive access-integrated protocol for aspiration or drainage of symptomatic uterine cysts. The design of the study is a prospective cohort study. The study setting is a tertiary care referral facility and university hospital. Twenty seven women with objective evidence of uterine cysts diagnosed by ultrasonography. The patients underwent transvaginal sonographic diagnosis of uterine cysts at different sites. Cyst aspiration was performed using interventional 2D ultrasonography, hysteroscopy and/or laparoscopy. Follow-up was performed for a maximum of 1 year to assess relief of symptoms and the recurrence rate. The main outcome measures of the study are success of aspiration tool, relief of symptoms, and persistence or recurrence rates. Cervical and corporeal uterine cysts were diagnosed in 19 and eight cases respectively. The mean size of the cervical cyst was 2.9±1.21 (1.8-3.7) cm, while that of the uterine cysts was 4.8±1.89 (3.4--6.1) cm. Improved health-related quality of life in the form of relief of deep dyspareunia and excessive vaginal discharge were reported in eight of 12 (66.6%) and 11/14 (78.5%) cases, respectively. Aspiration of symptomatic uterine cysts is technically feasible and achieves acceptable results. Uterine cysts may not be ignored as a potential cause of gynecologic symptoms, however, their precise pathogenesis and related co morbidities including impact on fertility should be substantiated by an adequately powered prospective randomized controlled study.