The Efficacy and Safety of Transvaginal Ethanol Sclerotherapy in the Treatment of Endometrial Cysts-A Systematic Review

Endometriosis, as a chronic disorder that is a source of severe pain ailments and infertility, requires a comprehensive therapeutic approach. Sclerotherapy, consisting of the administration of sclerosing agents into the cyst, is a constantly evolving minimally invasive treatment method for this dise...

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Bibliographic Details
Published in:International journal of molecular sciences 2024-01, Vol.25 (2), p.1337
Main Authors: Frankowska, Karolina, Dymanowska-Dyjak, Izabela, Abramiuk, Monika, Polak, Grzegorz
Format: Article
Language:English
Subjects:
Acetaldehyde
Alcohol
Alcohol, Denatured
Automation
Care and treatment
Complications and side effects
Cysts
Endometriosis
Endometriosis - drug therapy
Ethanol
Ethanol - adverse effects
Female
Fertility
Humans
Laparoscopy
Neoplasm Recurrence, Local - drug therapy
Ovarian Cysts - drug therapy
Ovaries
Pain
Pregnancy
Pregnancy Outcome
Reproductive technologies
Sclerotherapy
Sclerotherapy - adverse effects
Sclerotherapy - methods
Systematic review
Tetracycline
Tetracyclines
Treatment Outcome
Ultrasonic imaging
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Summary:Endometriosis, as a chronic disorder that is a source of severe pain ailments and infertility, requires a comprehensive therapeutic approach. Sclerotherapy, consisting of the administration of sclerosing agents into the cyst, is a constantly evolving minimally invasive treatment method for this disease. Hence, the main objective of this systematic review was to evaluate the impact of its most often used variant, transvaginal ethanol sclerotherapy, on endometriosis-related symptoms, endometrial cyst recurrence rate, ovarian reserve, assisted reproductive technology (ART) outcomes, and pregnancy outcomes, as well as to assess potential complications resulting from this treatment. This systematic review was undertaken using PubMed, Scopus, Web of Science, and Cochrane Library databases on 24 November 2023. The risk of bias in included studies was assessed with the use of the Newcastle-Ottawa scale (NOS) and the revised Cochrane risk of bias 2.0 tool for randomized controlled trials. From the 1141 records obtained from all databases, 16 studies have been included in this review. The use of ethanol sclerotherapy was characterized by a low rate of post-procedural complications. The recurrence rate of endometrial cysts after the procedure depended on the ethanol instillation time within the cyst. Although ethanol sclerotherapy had negligible influence on ovarian reserves when compared to laparoscopic cystectomy, the effects of both these methods on pregnancy outcomes were comparable. This review identifies that sclerotherapy is safe, provides significant relief of symptoms, and does not impair the reproductive potential of the patients.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms25021337