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Pelvic AbscessUTACNCT06988280

Ultrasound-guided Transvaginal Aspiration of Cystic Pelvic Lesions

An observational study of Pelvic Abscess and Adnexal Cyst, run by Universitaire Ziekenhuizen KU Leuven at 1 site in Belgium.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Adnexal cysts or pseudocysts are a common finding on transvaginal ultrasound, especially in premenopausal women. Due to the size of some cysts, they may cause discomfort. Moreover, a genuine risk of ovarian torsion presents when these lesions grow. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Pelvic Abscess, Adnexal Cyst, Ovarian Neoplasms
What is being tested?
Ultrasound-guided transvaginal aspiration of cystic pelvic lesions.
How many people
100 participants
Where
1 siteBelgium
Study dates
13 Mar 2025to Dec 2028
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Study population: All patients elligible based on the above mentioned criteria in University Hospitals Leuven.

Who may be able to join

None listed.

Who cannot join

  • Patients <18 years
  • Poor performance status contra-indicating the procedure
  • Vaginal stenosis (severe atrophy - virgo - vaginismus)
  • Purely solid lesions
  • Cystic lesions with a presumed malignant diagnosis and a risk of tumor dissemination in a curative setting
  • Physiological cysts in asymptomatic patients (in case of doubt the patient is reassessed after 3-6 months)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Belgium1 site, 1 recruiting
  • University Hospitals Leuven

    Leuven, Vlaams-Brabant, 3000

    Stefan Timmerman, MD, +32 16 34 47 50, stefan.timmerman@uzleuven.be

    Wouter Froyman, MD, PHD

    Recruiting

Other trials in Belgium

About this study

Adnexal cysts or pseudocysts are a common finding on transvaginal ultrasound, especially in premenopausal women. Due to the size of some cysts, they may cause discomfort. Moreover, a genuine risk of ovarian torsion presents when these lesions grow.

During the last decades, great advancements have been made in the correct differentiation of benign from malignant lesions. However, there still is controversy concerning the optimal treatment approach of symptomatic adnexal cysts with a low risk of malignancy, consisting of both surgery or ultrasound-guided transvaginal aspiration. Factors such as comorbidities and lesion characteristics need to be considered when counselling patients, as well as the possibility of short term recurrence.

Read more

Surgically removing them may result in longer hospital stays and recovery, with higher costs, while transvaginal needle aspiration techniques can be performed during a consultation. Additional benefits in avoiding surgery, particularly in women of reproductive age, are fertility preservation and less pelvic adhesions.

On the other hand, the main arguments against cyst aspiration are the relatively high recurrence rate of cysts, the minimal risk of malignant cell dissemination (In case of a false negative diagnosis) and the cytological instead of a histopathological examination.

With this in mind, it is important to base management decisions on the sonographic features of the lesions.

In addition, cyst aspiration can also be considered in large symptomatic cysts with a high risk of malignancy, but where curative treatment with surgical or chemotherapeutical intervention cannot be considered due to poor general condition of the patient. Especially in the absence of large volume ascites or peritoneal carcinomatosis, but with significant symptoms due to lesion size, cyst aspiration may give short term symptom alleviation. Given the risk of cancer cell dissemination, this intervention is always discussed in a multidisciplinary team discussion, to balance risk and benefits for patients with no other treatment options, Transvaginal needle aspiration is also being used in pelvic abscesses. The study of K. Gjelland et al. found that transvaginal aspiration combined with antibiotic treatment of pelvic abscesses is equally effective as surgically removing them. They state that this should be first-line treatment for abscesses, as it is minimally invasive, leading to better patient tolerance and avoiding the risks associated with anesthesia and surgery.

Saline irrigation of the abscess cavity can be performed, making the process of pus aspiration easier when the consistency is too viscous.

The literature still lacks studies about the symptom relief in patients receiving treatment for pelvic cystic lesions. Given that this is an important outcome parameter in determining the feasibility of performing procedures, more research in this area is needed.

The main aim of this prospective study is to evaluate the patient's symptom relief and cyst recurrence rate after ultrasound-guided transvaginal aspiration of pelvic cystic lesions or abscess drainage. Secondly, the safety and the patient's overall experience during as well as immediately after the procedure will be assessed.

Being tested
Ultrasound-guided transvaginal aspiration of cystic pelvic lesions.
Keywords
adnexal cyst, transvaginal aspiration, cyst recurrence, pelvic abscess, symptom relief
Medical subject headings
Ovarian Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ultrasound-guided transvaginal aspiration of cystic pelvic lesions.Diagnostic test

    Ultrasound-guided transvaginal aspiration is a minimally invasive procedure used to drain cystic pelvic lesions, such as adnexal cysts or pelvic abscesses. A thin needle is inserted through the vaginal wall under ultrasound guidance to aspirate fluid from the cyst, reducing its size.

Study groups in NCT06988280
Study groupRoleWhat they receive
Patients with pelvic cystic lesions (i.e adnexal lesions and abscesses)Patients with cystic lesions (i.e adnexal lesions and abscesses), undergoing an ultrasound-guided transvaginal drainage as per our standard of practice.
Receives: Diagnostic Test: Ultrasound-guided transvaginal aspiration of cystic pelvic lesions.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain on verbal rating scale (0-10)

    Pain scores indicated by the patient prior to the procedure, during the procedure, one week after and three months after the procedure.

    Measured: • Pain scores indicated by the patient prior to the procedure, during the procedure, one week after and three months after the procedure (based on a verbal rating scale).

  2. Recurrence of cyst (binary outcome after 12 months)

    Clinical and sonographic follow-up of possible recurrence (up till 12 months). Routine assessment will be done after 3 and 12 months

    Measured: 12 months

Secondary outcomes (2)
  1. General experience during the procedure (based on verbal rating scale 0-10)

    General experience during the procedure based on verbal rating scale, assessed after the procedure by an independent examiner.

    Measured: Right after the procedure to 3 days after.

  2. Complications (based on Clavien Dindo classification)

    Registration of adverse events, such as Vasovagal reaction, bleeding, infection, excessive pain.

    Measured: Immediately after the procedure to 6 weeks after the procedure.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 May 2025
  2. Study start13 Mar 2025
  3. Primary completionDec 2027 (estimated)
  4. Study completionDec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06988280
Sponsor's protocol ID
S68671
Acronym
UTAC
Status last verified
Mar 2025
First submitted
15 May 2025
Last updated
23 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: All IPD that underlie results in a publication will be added in the journal submission, and will be made available to other investigators on reasonable request.

Publications

  • Saokar A, Arellano RS, Gervais DA, Mueller PR, Hahn PF, Lee SI. Transvaginal drainage of pelvic fluid collections: results, expectations, and experience. AJR Am J Roentgenol. 2008 Nov;191(5):1352-8. doi: 10.2214/AJR.07.3808.

    PubMed 18941068
  • Feld R, Eschelman DJ, Sagerman JE, Segal S, Hovsepian DM, Sullivan KL. Treatment of pelvic abscesses and other fluid collections: efficacy of transvaginal sonographically guided aspiration and drainage. AJR Am J Roentgenol. 1994 Nov;163(5):1141-5. doi: 10.2214/ajr.163.5.7976890.

    PubMed 7976890
  • Caspi B, Goldchmit R, Zalel Y, Appelman Z, Insler V. Sonographically guided aspiration of ovarian cyst with simple appearance. J Ultrasound Med. 1996 Apr;15(4):297-300. doi: 10.7863/jum.1996.15.4.297.

    PubMed 8683664
  • Troiano RN, Taylor KJ. Sonographically guided therapeutic aspiration of benign-appearing ovarian cysts and endometriomas. AJR Am J Roentgenol. 1998 Dec;171(6):1601-5. doi: 10.2214/ajr.171.6.9843295.

    PubMed 9843295
  • Corsi PJ, Johnson SC, Gonik B, Hendrix SL, McNeeley SG Jr, Diamond MP. Transvaginal ultrasound-guided aspiration of pelvic abscesses. Infect Dis Obstet Gynecol. 1999;7(5):216-21. doi: 10.1002/(SICI)1098-0997(1999)7:53.0.CO;2-N.

    PubMed 10524665
  • Gjelland K, Ekerhovd E, Granberg S. Transvaginal ultrasound-guided aspiration for treatment of tubo-ovarian abscess: a study of 302 cases. Am J Obstet Gynecol. 2005 Oct;193(4):1323-30. doi: 10.1016/j.ajog.2005.06.019.

    PubMed 16202721
  • Urfali FE, Korkmaz M, Zeren S, Yaylak F, Tok Umay S. Percutaneous drainage as an rapid procedure for deep pelvic abscess in the emergency department. Ulus Travma Acil Cerrahi Derg. 2021 Sep;27(5):534-538. doi: 10.14744/tjtes.2020.99478.

    PubMed 34476798
  • Tsai CC, Shen CC, Changchien CC, Hsu TY, Kung FT, Chang SY, Chang MY, Huang FJ. Ultrasound-guided transvaginal cyst aspiration for the management of pelvic pseudocyst: a preliminary experience. Chang Gung Med J. 2002 Nov;25(11):751-7.

    PubMed 12553363
  • Timmerman D, Van Calster B, Testa A, Savelli L, Fischerova D, Froyman W, Wynants L, Van Holsbeke C, Epstein E, Franchi D, Kaijser J, Czekierdowski A, Guerriero S, Fruscio R, Leone FPG, Rossi A, Landolfo C, Vergote I, Bourne T, Valentin L. Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis group. Am J Obstet Gynecol. 2016 Apr;214(4):424-437. doi: 10.1016/j.ajog.2016.01.007. Epub 2016 Jan 19.

    PubMed 26800772
  • Duke D, Colville J, Keeling A, Broe D, Fotheringham T, Lee MJ. Transvaginal aspiration of ovarian cysts: long-term follow-up. Cardiovasc Intervent Radiol. 2006 May-Jun;29(3):401-5. doi: 10.1007/s00270-005-0167-0.

    PubMed 16502175
  • Diaz de la Noval B, Rodriguez Suarez MJ, Fernandez Ferrera CB, Valdes Lafuente D, Arias Cailleau R, Perez Arias H, Torrejon Becerra JC, Suarez Gil P, Lucio Gonzalez LR. Transvaginal Ultrasound-Guided Fine-Needle Aspiration of Adnexal Cysts With a Low Risk of Malignancy: Our Experience and Recommendations. J Ultrasound Med. 2020 Sep;39(9):1787-1797. doi: 10.1002/jum.15283. Epub 2020 Apr 16.

    PubMed 32298023
  • Garcia-Tejedor A, Castellarnau M, Burdio F, Fernandez E, Marti D, Pla MJ, Ponce J. Ultrasound-guided aspiration of adnexal cysts with a low risk of malignancy: is it a recommendable option? J Ultrasound Med. 2015 Jun;34(6):985-91. doi: 10.7863/ultra.34.6.985.

    PubMed 26014317
  • Kostrzewa M, Zajac A, Wilczynski JR, Stachowiak G. Retrospective analysis of transvaginal ultrasound-guided aspiration of simple ovarian cysts. Adv Clin Exp Med. 2019 Nov;28(11):1531-1535. doi: 10.17219/acem/104549.

    PubMed 31660708

Questions about this trial

What is this clinical trial studying?

An observational study of Pelvic Abscess and Adnexal Cyst, run by Universitaire Ziekenhuizen KU Leuven at 1 site in Belgium.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 0 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 23 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Stefan Timmerman, MD (+32 16 34 47 50, stefan.timmerman@uzleuven.be), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain on verbal rating scale (0-10) (time frame: • Pain scores indicated by the patient prior to the procedure, during the procedure, one week after and three months after the procedure (based on a verbal rating scale).). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06988280, which also lists 13 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 May 2025.

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