Traitement des endométriomes ovariens par sclérothérapie à l'éthanol. Evaluation d'efficacité et de sûreté.
Seance of wednesday 29 may 2024 (Communications Libres mai 2024)
DOI number : 10.26299/edmm-s529/emem.2024.18.06
Abstract
Ultrasound guided aspiration combined with ethanol sclerotherapy (EST) of ovarian endometriosis cysts is a minimally invasive surgical technique developed as an alternative to conventional surgery (cystectomy) in order to preserve the ovarian parenchyma.
This technique has already demonstrated its superiority in terms of fertility in patients with an endometrioma of more than 3cm in diameter, during in vitro fertilization treatment, compared to cystectomy.
Initially used to treat benign cysts occurring in different organs (thyroid, liver, kidney, etc.), more recent studies have evaluated this treatment in the management of endometriosis cysts and obtained recurrence rates ranging from 8 to 14.9% for an average follow-up of 12 months, these rates being lower than those of simple aspiration (83.3%) and comparable to those of conventional surgery.
EST can be performed on an outpatient basis, under local or general anesthesia. Using a transvaginal ultrasound probe, a control of the position and size of the endometrioma is performed. The content of the cyst is totally aspirated under visual control and sent to cytological study. After complete aspiration of the cyst, sterile 96% ethanol is instilled very slowly and kept for a period of 8 to 10 minutes, then aspirated completely. The procedure described is a modified version of the one published by Noma et al. (2001) and consistent with the one published by Yazbeck et al. (2009).
This technique has already demonstrated its superiority in terms of fertility in patients with an endometrioma of more than 3cm in diameter, during in vitro fertilization treatment, compared to cystectomy.
Initially used to treat benign cysts occurring in different organs (thyroid, liver, kidney, etc.), more recent studies have evaluated this treatment in the management of endometriosis cysts and obtained recurrence rates ranging from 8 to 14.9% for an average follow-up of 12 months, these rates being lower than those of simple aspiration (83.3%) and comparable to those of conventional surgery.
EST can be performed on an outpatient basis, under local or general anesthesia. Using a transvaginal ultrasound probe, a control of the position and size of the endometrioma is performed. The content of the cyst is totally aspirated under visual control and sent to cytological study. After complete aspiration of the cyst, sterile 96% ethanol is instilled very slowly and kept for a period of 8 to 10 minutes, then aspirated completely. The procedure described is a modified version of the one published by Noma et al. (2001) and consistent with the one published by Yazbeck et al. (2009).