Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPGONCALVES, Fernanda C.ANDRES, Marina P.PASSMAN, Leigh J.GONCALVES, Manoel O. C.PODGAEC, Sergio2016-10-172016-10-172016INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, v.134, n.1, p.3-7, 20160020-7292https://observatorio.fm.usp.br/handle/OPI/16395Background: Ovarian endometriosis is present in 17%-44% of women with endometriosis. The main treatment is surgery, but ultrasonography-guided aspiration is a less invasive alternative. Objectives: To evaluate the effectiveness of this alternative treatment in recurrent ovarian endometrioma. Search strategy: Multiple databases were searched for articles published between 1994 and 2014 using the keywords ""ultrasound-guided aspiration,"" ""ovarian,"" and ""endometriosis."" Selection criteria: Randomized controlled trials and observational studies published in English, Portuguese, or Spanish were included. Data collection and analysis: Two researchers independently extracted and reviewed the data. The main outcome of interest was the recurrence rate. Main results: Eight studies were eligible. Ovarian endometriosis is associated with high recurrence rates after one ultrasonography-guided aspiration (28.9%-91.5%), but involves less ovarian manipulation. The results of aspiration followed by sclerotherapy are not uniform, but overall the addition of a sclerosing agent does not seem to significantly reduce the likelihood of recurrence (13.3%-75.0%). Repeated aspiration of the cysts can reduce the recurrence rate to 5.4% by the sixth aspiration. Conclusions: Repeated ultrasonography-guided aspiration of ovarian endometriomas can be performed for the treatment of recurrent ovarian endometriosis. Further studies comparing the efficacy of this procedure and ovarian surgery are needed.engrestrictedAccessOvarian endometriosisTreatmentUltrasonography-guided aspirationpelvic endometriosissclerotherapymanagementsurgerycystswomendiagnosisinjectiondrainagetherapyarticleCopyright ELSEVIER IRELAND LTD10.1016/j.ijgo.2015.10.021Obstetrics & Gynecology1879-3479