Ethanol sclerotherapy of ovarian endometrioma: a safe and effective minimal invasive procedure. Preliminary results.
OBJECTIVE
To study if ultrasound-guided aspiration with ethanol sclerosis is a safe and effective treatment for endometriomas.


METHODS
We conducted a prospective study of 25 women with 27 endometriomas (two bilateral) measuring 4-10cm in diameter with no suspected malignancy, who underwent ultrasound-guided aspiration and ethanol sclerosis between August 2010 and July 2014. Patients were followed up by ultrasound at 6, 12, 24, and 36 months to identify rates of complication and recurrence. Clinical characteristics of the patients (age, history of infertility, previous surgery, and abdominal pain), the cysts (location, diameter, and volume) and the procedure (duration and complications) were recorded. Kaplan-Meier survival curves were used to analyze the recurrence rates by SPSS statistical software.


RESULTS
The recurrence rate after sclerosis was 12%. The mean length of follow-up was 17 (SD 9.9) months. Although no major procedure-related complications were recorded, minor complications included three cases of low abdominal pain during the procedure (10.7%) and two cases of abdominal ethanol extravasation (7.1%).


CONCLUSIONS
Ultrasound-guided aspiration and ethanol sclerotherapy are a safe and effective treatment for endometriomas measuring 4-10cm in diameter with no evidence of malignancy. This conservative treatment could possibly achieve a symptomatic cure while preserving healthy ovarian tissue, thereby improving fertility outcomes and avoiding early menopause.
Department of Gynecology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain. Electronic address: agarciat@bellvitgehospital.cat.
Amparo
A
García-Tejedor
Universitat Autònoma de Barcelona. Departments of Obstetrics and Gynecology, Hospital General de l'Hospitalet, Barcelona, Spain.
Marta
M
Castellarnau
Department of Gynecology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
Jordi
J
Ponce
Department of Gynecology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
Ma Eulalia
ME
Fernández
Department of Surgery, Hospital del Mar, Barcelona, Spain.
Fernando
F
Burdio
D000328:Adult; D004715:Endometriosis / Q000473:pathology / Q000628:therapy*; D000431:Ethanol; D005260:Female; D005298:Fertility; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D015911:Sclerotherapy / Q000379:methods*; D013396:Suction / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
D000431:Ethanol
Endometriosis; Ethanol sclerotherapy; Fertility preservation; Ovary; Ultrasound