Laparoscopic Assessment of the Ovaries after Resolving the Endometriomas with Ultrasound-guided Transvaginal Ethanol Sclerotherapy

Izabela Dymanowska, Karolina Frankowska, Sara Moqbil, Monika Abramiuk, Piotr Stachurski, Elżbieta Witt, Grzegorz Polak
In: Gynecology and Minimally Invasive Therapy · 2026 · vol. 15(3) , pp. 269–273 · doi:10.4103/gmit.gmit-d-25-00055 · W7169521795
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Laparoscopic assessment after ultrasound-guided transvaginal ethanol sclerotherapy for ovarian endometriomas revealed preserved pelvic anatomy and normal ovarian appearance, indicating no excessive adhesion formation.

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Abstract

Ultrasound-guided transvaginal ethanol sclerotherapy belongs to one of the minimally invasive methods for endometrioma management. Nevertheless, some reports suggested a possible link between the method and the presence of pelvic adhesions. Therefore, our study aimed to describe ultrasound-guided transvaginal sclerotherapy with high-percentage ethanol, which resulted in the preservation of normal anatomy of the minor pelvis and the normal appearance of affected ovaries in the laparoscopic images obtained during postsclerotherapy surgeries. We present four cases of patients who underwent laparoscopic surgeries several months after ethanol sclerotherapies for ovarian endometriomas. During sclerotherapies, cyst fluid was aspirated under ultrasound guidance, cyst cavities were flushed with saline, and then filled with 96% ethanol to 60% of their initial volume for 10 min. The reported cases demonstrate that ultrasound-guided transvaginal ethanol sclerotherapy did not cause excessive adhesion formation or affect ovarian morphology. Therefore, it seems that this treatment method does not adversely affect fertility.

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