Comparison of therapeutic effects for ultrasound-guided interventional sclerotherapy and surgical operation in ovarian endometriomas

Objective To compare the therapeutic effects of ultrasound-guided interventional sclerotherapy with surgical operation in ovarian endometriomas.Methods Four hundred and sixty patients were classified into two groups:(1)interventional group: two hundred and thirty-one patients received ultrasound-guided interventional sclerotherapy in out-patient department including 41 cases of postoperation recurrence and 2 cases of recurrence after interventional therapy.There were 5 patients also receiving medical therapy just like those after surgical operation while 139 other patients received no more treatment.(2) surgical operative group: There were 229 patients receiving laparoscopy or laparotomy in the operation room.They also received routine postoperative medical therapy for 3 to 6 months(mostly with Diphereline or Zoledex but 1 with gestrinone).Results Two hundred and fifteen patients(93.1%) in interventional group showed complete vanishment on ultrasound examination after only one treatment and these patients left the clinic by themselves.Among the other 16 patients,11 with bilateral cysts received two treatments each for one cyst.The other 5 cases received two treatments owing to the incomplete vanishment of the big lesion size on the first treatment.One hundred and forty-four patients(62.3%) in this group came for follow-up,87 cases were lost for different reasons.Seventy-seven patients showed complete disappearance of the cysts.Forty cases showed cyst shrinkage and symptoms relieved or recovered.Twenty-seven cases(18.8%) had recurrence.Thirteen patients each had given birth to one baby.Two hundred and twenty-six patients in the surgical operative group(98.7%) received cystectomy and 3 received ovariotomy.They had been in hospital for 3-29 days(average 9.2 days).Of them 130 patients were followed(56.8%),99 cases were lost.Twenty-four cases(18.5%) had recurrence.There were 1 tubal pregnancy and 11 intrauterine pregnancies were found after the operation including 1 death fetal and 3 term deliveries.Conclusions The surgical operation and ultrasound-guided interventional sclerotherapy were both effective in treating ovarian endometriomas.The interventional therapy which were carried out in out-patient clinic was cheap and safe compared to the surgical operation and can be reduplicated if necessary.It is a method worthy of special attention in case of disease recurrence.