Ethanol sclerotherapy of ovarian endometrioma: a safe and effective minimal invasive procedure. Preliminary results

Abstract Objective To study if ultrasound-guided aspiration with ethanol sclerosis is a safe and effective treatment for endometriomas. Study design We conducted a prospective study of 25 women with 27 endometriomas (two bilateral) measuring 4–10 cm 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%). Conclusion Ultrasound-guided aspiration and ethanol sclerotherapy are a safe and effective treatment for endometriomas measuring 4–10 cm 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.