Sclerosing therapy for Endometriomas

Sclerosing therapy for Endometriomas

** Endometriosis is a common gynecological disorder; it is the implantation of endometrial tissue outside of the uterine cavity.

** the most common site for endometriosis is pelvic organs especially the ovaries.

** endometrial implants on the ovary can encyst and form chocolate cysts (endometriomas).

** endometriomas are usually adherent to the ovaries and any attempt to remove them surgically will result in the loss of significant part of the ovaries hence decreasing the ovarian reserve.

** the scientific community has been looking for methods to treat these endometriomas without surgical interventions in order to prevent the decline in ovarian reserve.

** using the sclerosing agent ethanol is one of these methods.

What is the mechanism of action of ethanol?

Protein denaturation and fibrosis of cyst wall.

How is the procedure performed?

• Aspiration of cyst content
• Installation of ethanol 95%
• Retain the ethanol for 10 minutes and then aspirate it

Why is ethanol the preferred agent?

Better outcome and availability

What are the patient criteria for endometrioma sclerosing treatment?

- women who want to preserve fertility with symptomatic endometriomas

- surgery is contraindicated

- recurrence after surgery

What are contraindications for this mode of treatment?

• Suspected malignancy
• Pelvic infection
• Pregnancy

What is the success rate of this procedure?

88%

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist