Sclerotherapy for Recurrent Endometrioma

Background: Endometioma is a benign, cystic disease in women of reproductive age. Traditionally endometrioma is managed surgically. However sclerotherapy under ultrasound guide (USG) is another less invasive method of management. In this study we performed sclerotherapy for those who had undergone laparoscopic cystectomy and presented with recurrence. Methods: 22 women with recurrent endometrioma after previous laparoscopic cystectomies. Aspiration of the cysts was performed under USG then cysts were irrigated and washed clean by sodium chloride 9% then the cavity was irrigated by 96% ethanol and aspirated after 5 minutes. Finally ethanol was left in thecyst with a volume equivalent to 50-70% of the original cyst volume. The patients were followed and reevaluated at one, three, six and 12 months after the procedure for their pain, antral follicular count, and recurrence of the disease. Also serum levels for Ca125, AMH, FSH and estradiol were measured and compared. Results: The mean age was 30.8±1.94 years. The mean FSH declines from 9.10±.71 to 8.73±.78 from the 3rd to the 12th month (p= 0.001). AMH mildly increased from 1.523±.34 to 1.573±.29 (p=0.155). The mean AMH increased from 6.27±1.48 to 7.45±1.80 (p=0.002). Their pain score reduced to 1/10 in the third month (p=0.005). The mean estradiol increased from 70.52±51.2 to 74.09±46.7 (p=0.033). Ca125 reduced during the study period however the value was not statistically significant. 3 women had spontaneous pregnancy and one had IVF pregnancy. Conclusion: sclerotherapy by ethanol is a safe and effective method for the management of recurrent endometriomas.

کلیدواژه ها:

Recurrent Endometrioma ، Sclerotherapy