Three RCTs (n=270) were included in this review.
Overall, the trials were judged to be of fair methodological quality: all were randomised, although only one had clear allocation concealment. Blinding was not practical given the intervention, but no studies reported the use of blinded assessors.
Two trials (n=197) reported on hospitalisation and indicated that needle aspiration significantly reduced the need for hospital admission (RR 0.26, 95% CI: 0.17, 0.39; RR 0.51, 95% CI: 0.36, 0.74).
Two trials (n=197) reported on 1-week failure rates and suggested that these were comparable between the two intervention groups (RR 0.86, 95% CI: 0.34, 2.18; RR 0.49, 95% CI: 0.10, 2.33).
All 3 trials (n=270) found no significant differences in 1-year recurrence rates between the two intervention groups (RR 1.04, 95% CI: 0.58, 1.89; RR 0.95, 95% CI: 0.41, 2.22; RR 0.54, 95% CI: 0.21, 1.43).
All 3 trials (n=270) reported on the duration of hospital stay in those patients who were hospitalised and suggested that overall needle aspiration resulted in a shorter hospital stay. Two trials reported a significant reduction in duration of hospital stay.
All 3 trials reported patient comfort and analgesia use in different ways, giving rise to conflicting results (details provided).