[Role of ultrasound guided puncture in the management of ovarian cysts].

Ultrasound guided aspiration of ovarian cysts should be performed in well defined indications and under precise and strict modalities. Preoperative evaluation should include vaginal sonography and serum levels of CA125 and CA 19/9. Ultrasound guided aspiration is allowed only in cases of sonographically benign cyst: unilateral unilocular homogenous anechogenic cyst less than 7 cm, and serum levels of CA125 and CA 19/9 less than 35 Ul/ml. The technique of ultrasound guided aspiration is similar to the one used for oocytes recovery in in vitro fertilization treatments. It is mandatory to perform a macroscopic, cytologic and biologic (with concentrations of estradiol, CA125 and CA 19/9) evaluation of cyst fluid. Patients should be told that in case of abnormalities of cyst fluid, a laparoscopy has to be performed immediately or as soon as possible, and that there is a risk of recurrence of the ovarian lesion.