International Journal of Gynecology and Obstetrics 81 (2003) 41–45 0020-7292/03/$30.00  2002 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved. PII: S0020-7292 Ž 02 . 00401-0 Article Management of non-neoplastic ovarian cysts with sclerotherapy H. Kafali *, S. Yurtseven , F. Atmaca , I. Ozardali a, a b c Department of Obstetrics and Gynecology, Medical School, Harran University, Sanliurfa, Turkey a Department of Obstetrics and Gynecology, Sanliurfa State Hospital, Sanliurfa, Turkey b Department of Pathology, Medical School, Harran University, Sanliurfa, Turkey c Received 24 July 2002; received in revised form 19 November 2002; accepted 20 November 2002 Abstract Objective: To evaluate sclerotherapy with alcohol and erythromycin in the management of simple ovarian cysts. Methods: Twenty-four simple ovarian cysts were subjected to sclerotherapy with alcohol and erythromycin. All procedures were performed under local anesthesia and in an outpatient setting. Cytological examination was carried out in all cases and two patients were excluded from the study because of suspicious cytological results. The patients were followed up monthly with color Doppler sonography for more than 12 months. Results: Cyst fluid was serous in 17 cases and dark-chocolate colored in seven cases. The volume of aspirated fluid ranged from 100 to 220 ml. The size of ovarian masses and cyst-wall thickness ranged from 5.5 to 8.5 cm and 1.5 to 5 mm, respectively. Cytological analysis of 15 cysts revealed acellular sediment, seven cysts were compatible with endometrioma, and two were reported as suspicious. During the 12-month follow-up, seven cyst recurrences were detected. Conclusion: Aspiration and sclerotherapy with alcohol and erythromycin are followed by a relatively high recurrence rate when the aspirate is bloody. However, patients with a simple cyst that is painful or liable to torsion could benefit from sclerotherapy. Such patients, who are at low risk for malignancy, are relieved with sclerotherapy while avoiding surgery.  2002 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved. Keywords: Sclerotherapy; Alcohol; Erythromycin; Ovarian cyst 1. Introduction Differential diagnosis in the management of an adnexal mass is complex because of the scope of the disorders that may have caused it and the numerous therapies that may be appropriate. It is *Corresponding author. Tel.: q90-414-314-2159; fax: q90- 414-316-8821. E-mail address: hasankafali@hotmail.com (H. Kafali). the risk of malignancy that propels protocols and procedures, as well as the fundamental concept that early diagnosis and treatment in cancer are related to lesser mortality and morbidity. Non- neoplastic ovarian cysts in women with menstrual cycles are the most frequently detected masses involving the adnexa. Many of these cysts are functional and resolve spontaneously within a few days to 2 weeks, but they can persist longer.