Catheter-directed Sclerotherapy for Ovarian Endometrioma: Short-term Outcomes

Radiology · 2018 · vol. 289(3) , pp. 854–859 · doi:10.1148/radiol.2018180606 · PMID:30152743 · W2889217215
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Catheter-directed sclerotherapy with 95% ethanol reduced ovarian endometrioma size and recurrence with preserved ovarian function and no complications.

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This prospective study evaluated catheter-directed sclerotherapy using 95% ethanol in 14 participants with primary or recurrent ovarian endometriomas, assessing effects on endometrioma size, pain, serum CA-125, and ovarian reserve via anti-Müllerian hormone (AMH) before treatment and 6 months after, with ultrasound follow-up at multiple time points. Mean endometrioma size decreased significantly from 5.8 cm to 1.1 cm, pain was relieved in all participants, CA-125 levels decreased, and no endometrioma recurrences were reported during a mean follow-up of 12.7 months; AMH did not change, and no procedure-related complications occurred. The main caveats are the small sample size and short-term follow-up without a control group. This paper is centrally about endometriosis — specifically catheter-directed ethanol sclerotherapy for ovarian endometriomas and its short-term outcomes and ovarian reserve effects.

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Abstract

Purpose To evaluate the effectiveness of catheter-directed sclerotherapy (CDS) with 95% ethanol in patients with primary or recurrent ovarian endometriomas. Materials and Methods In this prospective study, 14 participants (mean age, 32 years; range, 20-44 years) who underwent CDS for ovarian endometrioma from March 2015 to December 2017 were evaluated. Diagnosis was based on symptoms and imaging studies. To assess the impact of CDS on ovarian reserve, serum anti-Müllerian hormone (AMH) was measured before CDS and 6 months after CDS. Serum cancer antigen 125 (CA-125) levels were also measured at the same time points. Follow-up US was performed 1, 3, and 6 months after CDS and biannually thereafter to monitor potential cyst size change and recurrence. Comparison of AMH, CA-125, and cyst size before and after CDS was performed by using the paired t test or Wilcoxon signed-rank test. Results Mean endometrioma size decreased from 5.8 cm ± 2.2 to 1.1 cm ± 1 (P ˂ .001). During a mean follow-up of 12.7 months (range, 6.1-23.0 months), there were no recurrences of endometrioma. Pain was relieved in all participants, with a decrease in serum CA-125 level (P = .001). There was no difference in serum AMH level before and 6 months after CDS, indicating well-preserved ovarian function (4.29 ng/mL ± 2.47 vs 4.36 ng/mL ± 1.94, respectively; P > .875). There were no procedure-related complications. Conclusion Catheter-based sclerotherapy with 95% ethanol can lead to better short-term clinical outcomes and well-preserved ovarian function for patients with endometriomas. © RSNA, 2018.
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YUHASpace Repository 0 1061 Cited 0 times in Cited 27 times in Catheter-directed Sclerotherapy for Ovarian Endometrioma: Short-term Outcomes - Authors - Kichang Han ; Seok Kyo Seo ; Man-Deuk Kim ; Gyoung Min Kim ; Joon Ho Kwon ; Hee Joon Kim ; Jong Yun Won ; Do Yun Lee - Citation - RADIOLOGY, Vol.289(3) : 854-859, 2018 - Journal Title - RADIOLOGY - ISSN - 0033-8419 - Issue Date - 2018 - Abstract - Purpose To evaluate the effectiveness of catheter-directed sclerotherapy (CDS) with 95% ethanol in patients with primary or recurrent ovarian endometriomas. Materials and Methods In this prospective study, 14 participants (mean age, 32 years; range, 20-44 years) who underwent CDS for ovarian endometrioma from March 2015 to December 2017 were evaluated. Diagnosis was based on symptoms and imaging studies. To assess the impact of CDS on ovarian reserve, serum anti-Müllerian hormone (AMH) was measured before CDS and 6 months after CDS. Serum cancer antigen 125 (CA-125) levels were also measured at the same time points. Follow-up US was performed 1, 3, and 6 months after CDS and biannually thereafter to monitor potential cyst size change and recurrence. Comparison of AMH, CA-125, and cyst size before and after CDS was performed by using the paired t test or Wilcoxon signed-rank test. Results Mean endometrioma size decreased from 5.8 cm ± 2.2 to 1.1 cm ± 1 (P ˂ .001). During a mean follow-up of 12.7 months (range, 6.1-23.0 months), there were no recurrences of endometrioma. Pain was relieved in all participants, with a decrease in serum CA-125 level (P = .001). There was no difference in serum AMH level before and 6 months after CDS, indicating well-preserved ovarian function (4.29 ng/mL ± 2.47 vs 4.36 ng/mL ± 1.94, respectively; P > .875). There were no procedure-related complications. Conclusion Catheter-based sclerotherapy with 95% ethanol can lead to better short-term clinical outcomes and well-preserved ovarian function for patients with endometriomas. - Appears in Collections: - 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers 1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers - Yonsei Authors - Kwon, Joon Ho(권준호) https://orcid.org/0000-0002-6178-7252 Kim, Gyoung Min(김경민) https://orcid.org/0000-0001-6768-4396 Kim, Man Deuk(김만득) https://orcid.org/0000-0002-3575-5847 Kim, Hee Joon(김희준) Seo, Seok Kyo(서석교) https://orcid.org/0000-0003-3404-0484 Won, Jong Yun(원종윤) https://orcid.org/0000-0002-8237-5628 Lee, Do Yun(이도연) Han, Ki Chang(한기창) https://orcid.org/0000-0002-9701-9757 Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Ovarian Diseases Sclerotherapy Sclerotherapy Adult Catheters Endometriosis Endometriosis Ethanol Ethanol Female Fluoroscopy Humans Ovarian Diseases Ovarian Diseases Ovary Ovary Prospective Studies Radiography, Interventional Sclerotherapy

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