Endometriosis Sclerotherapy

Sclerotherapy in Endometriosis – A Comprehensive Guide

What is Sclerotherapy in Endometriosis?

Sclerotherapy is a minimally invasive method primarily used in the treatment of ovarian endometriomas (chocolate cysts). It aims to shrink the cyst and reduce its recurrence by injecting a sclerosing agent into it.

In Which Patients Is It Used?

It is generally preferred in selected patients as an alternative to surgery. It can be applied especially in patients who desire fertility, carry surgical risks, or have recurrent endometriomas.

How Is It Applied?

Under ultrasound guidance, the cyst content is aspirated, and then a sclerosing agent (usually ethanol) is injected into the cyst and left for a certain period. Afterwards, the fluid is drained.

Advantages

Its most significant advantages include being minimally invasive, causing less damage to ovarian reserve, being applicable in a short time, and not requiring hospitalization.

Disadvantages and Risks

The risk of recurrence may be higher compared to surgery. Additionally, there is a risk of infection, pain, and rarely, damage to surrounding tissues.

Sclerotherapy or Surgery?

Surgery (especially excision) is more effective in long-term outcomes. However, depending on patient selection, sclerotherapy can be a good alternative.

Effect on Fertility

Since sclerotherapy can better preserve ovarian tissue, it may offer an advantage in terms of fertility for some patients.

When Is It Not Preferred?

It is not preferred in the presence of suspected malignancy, complex cyst structure, or advanced-stage deep infiltrative endometriosis.

Conclusion

Sclerotherapy in endometriosis is an effective treatment option for selected patients. However, patient selection and experienced application are of great importance.