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Review
. 2025 Mar 26;17(3):e81215.
doi: 10.7759/cureus.81215. eCollection 2025 Mar.

Future of Sclerotherapy in the Treatment of Endometriosis: A Narrative Literature Review

Dimitrios Lentzaris  1 , Fani Gkrozou  1 , Chara Skentou  1 , Nikoleta Koutalia  1 , Vasileios Bais  1 , Anastasia Vatopoulou  1 , Minas Paschopoulos  1
Affiliations
Review

Future of Sclerotherapy in the Treatment of Endometriosis: A Narrative Literature Review

Dimitrios Lentzaris et al. Cureus. .

Abstract

Endometriosis is a gynaecological condition affecting reproductive-age women. In case of ovarian endometriosis, there is cystic formation, called endometrioma. Although laparoscopic cystectomy is established as the gold standard for the treatment of endometriomas, it is related to damage of healthy ovarian tissue and significant decrease in ovarian reserve. As a result, new strategies have been set for the care of endometriomas, with ethanol sclerotherapy as the most popular alternative. As a part of sclerotherapy, ethanol solution is injected to destroy pseudocapsule. Iatrogenic damage is minimized, making it a safe and less invasive technique. In this study, we compared ultrasound-guided (U/S) ethanol sclerotherapy and laparoscopic ethanol sclerotherapy with laparoscopic cystectomy. Anti-Müllerian hormone (AMH) is used to monitor ovarian preservation. Sclerotherapy seems to have smaller effect on ovarian reserve compared to cystectomy. Recurrence rate and clinical pregnancy rate are similar, though cystectomy has better outcome of symptom relief. Moreover, laparoscopic sclerotherapy seems to achieve the best clinical pregnancy rate and decrease recurrence rate.

Keywords: cystectomy; endometriomas; endometriosis; fertility preservation; ovarian cysts; ovarian reserve; sclerotherapy.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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Figure 1
Figure 1. Study selection
PRISMA flow diagram PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
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