{"paper_id":"14406607-38cb-4513-8443-46b958595e75","body_text":"Abstract\nObjectives\nTo compare the efficacies of catheter-directed sclerotherapy (CDS) with 99% ethanol and surgery for ovarian endometrioma and their impact on the ovarian reserve.\nMethods\nFrom January 2011 to June 2019, 71 patients who underwent surgical excision (n = 51) or CDS (n = 20) for symptomatic ovarian endometriomas were reviewed. To analyze the effect on the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were compared before and after the procedure. Symptoms, serum cancer antigen 125 (CA-125), lesion size, recurrence, hospitalization, and complications were reviewed retrospectively.\nResults\nDuring a mean follow-up of 22.3 months (range, 6 to 94 months), no significant difference in symptom relief was found between CDS and surgery (95.0% [19/20] and 92.2% [47/51], respectively, p > 0.999). The hospital stay was shorter with CDS than with surgery (2.6 ± 0.6 days and 4.1 ± 0.5 days, respectively, p < 0.001). There was no significant difference in serum AMH levels before and after CDS (2.3 (interquartile range (IQR) 1.1–5.3) ng/mL and 2.6 (IQR 0.9–4.9) ng/mL, respectively, p = 0.243), but there was a significant decrease in serum AMH in the surgery group (3.0 (IQR 1.3–5.5) ng/mL and 1.6 (IQR 0.7–3.2) ng/mL, respectively, p < 0.001). CA-125 decreased in both CDS and surgery groups (p = 0.001 and < 0.001, respectively). Two minor complications occurred in the surgery group, while no complication was observed in the CDS group.\nConclusions\nThe therapeutic efficacy of CDS appears to be comparable to that of surgical resection for ovarian endometrioma. Ovarian function was well-preserved, and a shorter hospital stay was required in patients who underwent CDS.\nKey Points\n• There was no significant difference in symptom relief between CDS and surgery (95.0% [19/20], 92.2% [47/51], respectively, p >0.999).\n• No significant difference in serum AMH levels was seen before and after CDS (2.3 (1.1, 5.3)* ng/mL, 2.6 (0.9, 4.9)* ng/mL, respectively, p = 0.243), whereas serum AMH levels significantly decreased after surgical resection (3.0 (1.3, 5.5)* ng/mL, 1.6 (0.7, 3.2)* ng/mL, respectively, p <0.001). *Median (25 quartiles, 75 quartiles)\n• The hospitalization period was shorter with CDS than with surgery (2.6 ± 0.6 days, 4.1 ± 0.5 days, respectively, p <0.001).\nSimilar content being viewed by others\nAbbreviations\n- AMH:\n-\nAnti-Müllerian hormone\n- CDS:\n-\nCatheter-directed sclerotherapy\n- NDS:\n-\nNeedle-directed sclerotherapy\n- CA-125:\n-\nSerum cancer antigen 125\nReferences\nGiudice LC (2010) Clinical practice. 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Obstet Gynecol Sci 57:297–303\nFunding\nThis study was supported by a faculty research grant of Yonsei University College of Medicine (6-2020-0007).\nAuthor information\nAuthors and Affiliations\nCorresponding authors\nEthics declarations\nGuarantor\nThe scientific guarantor of this publication is Kichang Han.\nConflict of interest\nThe authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.\nStatistics and biometry\nNo complex statistical methods were necessary for this paper.\nInformed consent\nWritten informed consent was waived by the Institutional Review Board.\nEthical approval\nInstitutional Review Board approval was obtained.\nStudy subjects or cohorts overlap\nFourteen of the 20 patients who had undergone CDS have been previously reported [13]. The prior study was a single-arm study lacking a control group, whereas in this manuscript, we compared CDS with surgical resection.\nMethodology\n• Retrospective\n• Observational\n• Performed at one institution\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nKoo, J.H., Lee, I., Han, K. et al. Comparison of the therapeutic efficacy and ovarian reserve between catheter-directed sclerotherapy and surgical excision for ovarian endometrioma. Eur Radiol 31, 543–548 (2021). https://doi.org/10.1007/s00330-020-07111-1\nReceived:\nRevised:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00330-020-07111-1","source_license":"CC0","license_restricted":false}