Ultrasound-guided ethanol sclerotherapy versus laparoscopic surgery for endometriomas: a randomized clinical trial in a real-world setting
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| Publicado en: | Archives of Gynecology and Obstetrics vol. 312, no. 6 (Dec 2025), p. 2199 |
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| Outros autores: | , , , , , , , , , , , , , , , , , , , , , |
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Springer Nature B.V.
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| Acceso en liña: | Citation/Abstract Full Text Full Text - PDF |
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| 001 | 3283141934 | ||
| 003 | UK-CbPIL | ||
| 022 | |a 0932-0067 | ||
| 022 | |a 1432-0711 | ||
| 022 | |a 0003-9128 | ||
| 022 | |a 0170-9925 | ||
| 024 | 7 | |a 10.1007/s00404-025-08205-1 |2 doi | |
| 035 | |a 3283141934 | ||
| 045 | 2 | |b d20251201 |b d20251231 | |
| 100 | 1 | |a García-Tejedor, Amparo |u Hospital Universitari Bellvitge, Universitat de Barcelona, , Hospitalet de Llobregat, Bellvitge Hospital, Department of Gynecology, Facultat de Medicina, Barcelona, Spain (GRID:grid.411129.e) (ISNI:0000 0000 8836 0780); IDIBELL, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (GRID:grid.418284.3) (ISNI:0000 0004 0427 2257) | |
| 245 | 1 | |a Ultrasound-guided ethanol sclerotherapy versus laparoscopic surgery for endometriomas: a randomized clinical trial in a real-world setting | |
| 260 | |b Springer Nature B.V. |c Dec 2025 | ||
| 513 | |a Journal Article | ||
| 520 | 3 | |a PurposeTo compare the efficacy of ultrasound-guided alcohol sclerotherapy versus laparoscopic cystectomy for the management of ovarian endometriomas, focusing on complications, recurrence, pain relief, and healthcare costs.MethodsWe conducted a multicentre, randomized clinical trial across 20 centers in Spain. A total of 167 women aged 18–40 years with ovarian endometriomas (35–100 mm) were recruited between June 2018 and June 2022. Participants were randomized to receive either ultrasound-guided aspiration with ethanol sclerotherapy or standard laparoscopic cystectomy. Complications were graded using the Clavien–Dindo classification. Pain was assessed using a visual analogue scale (VAS) before and six months after treatment. Recurrence was defined as the reappearance of a cystic lesion at the treated site and analyzed using Kaplan–Meier curves and log-rank tests. The primary analysis followed an intention-to-treat approach and included 158 patients (sclerotherapy: n = 84; cystectomy: n = 74). The per-protocol analysis included 92 patients (sclerotherapy: n = 57; cystectomy: n = 37). Direct hospital costs, complication rates, recurrence, and pain relief were compared between groups.ResultsIntention-to-treat analyses show that complications were low in both groups (12%), most of which were Grade I–II, although 4.1% were Grade III in the surgery group. The cost of sclerotherapy was significantly lower (€472 vs. €2128, p < 0.001). In per-protocol analyses, the cyst recurrence or reappearance was similar between the two groups, with rates of 25.7% (9 of 35) in the surgery group and 22.8% (13 of 57) in the sclerotherapy group (p = 0.16). Pain was improved or completely resolved in 49 of 55 cases (89.1%) in the sclerotherapy group and in 21 of 32 cases (65.7%) in the laparoscopic surgery group (p = 0.05).ConclusionsUltrasound-guided alcohol sclerotherapy is a safe, cost-effective alternative to laparoscopic cystectomy for the treatment of endometriomas, with comparable recurrence rates and pain relief. Clinical Trial Registration: <ext-link xlink:href="https://clinicaltrials.gov/search?term=NCT03571776" ext-link-type="uri">https://clinicaltrials.gov/search?term=NCT03571776</ext-link>. Registered May 5, 2018. | |
| 651 | 4 | |a Spain | |
| 651 | 4 | |a United States--US | |
| 653 | |a Sclerotherapy | ||
| 653 | |a Patients | ||
| 653 | |a Womens health | ||
| 653 | |a Cysts | ||
| 653 | |a Ovaries | ||
| 653 | |a Laparoscopy | ||
| 653 | |a Pain | ||
| 653 | |a Cost analysis | ||
| 653 | |a Endometriosis | ||
| 653 | |a Infertility | ||
| 653 | |a Urological surgery | ||
| 653 | |a Hospital costs | ||
| 653 | |a Ultrasonic imaging | ||
| 653 | |a Ethanol | ||
| 700 | 1 | |a Guevara-Peralta, Rodrigo |u Hospital Universitari Bellvitge, Universitat de Barcelona, , Hospitalet de Llobregat, Bellvitge Hospital, Department of Gynecology, Facultat de Medicina, Barcelona, Spain (GRID:grid.411129.e) (ISNI:0000 0000 8836 0780); Universitat de Barcelona, Hospitalet de Llobregat, Facultat de Medicina, Departament de Ciències Clíniques, Barcelona, Spain (GRID:grid.5841.8) (ISNI:0000 0004 1937 0247) | |
| 700 | 1 | |a Martinez-Garcia, Jose Manuel |u Hospital Universitari Bellvitge, Universitat de Barcelona, , Hospitalet de Llobregat, Bellvitge Hospital, Department of Gynecology, Facultat de Medicina, Barcelona, Spain (GRID:grid.411129.e) (ISNI:0000 0000 8836 0780); IDIBELL, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (GRID:grid.418284.3) (ISNI:0000 0004 0427 2257) | |
| 700 | 1 | |a Corbalán, Shiana |u Hospital Los Arcos, Department of Gynecology, Murcia, Spain (GRID:grid.418284.3) | |
| 700 | 1 | |a Agüero, Mauricio |u Hospital del Mar, Department of Gynecology, Barcelona, Spain (GRID:grid.411142.3) (ISNI:0000 0004 1767 8811) | |
| 700 | 1 | |a Gomez-Romero, Maria |u Hospital Joan XXIII, Department of Gynecology, Tarragona, Spain (GRID:grid.411435.6) (ISNI:0000 0004 1767 4677) | |
| 700 | 1 | |a Cararach, Marta |u Hospital de Viladecans, Department of Gynecology, Barcelona, Spain (GRID:grid.459594.0) (ISNI:0000 0004 1767 5311) | |
| 700 | 1 | |a Castellarnau, Marta |u Consorci Integral, Hospitalet de Llobregat, Department of Gynecology, Barcelona, Spain (GRID:grid.417656.7) | |
| 700 | 1 | |a Rodríguez, Mariví |u Department of Gynecology, Hospital San Pedro, Logroño, Spain (GRID:grid.460738.e) | |
| 700 | 1 | |a Lou-Mercadé, Ana Cristina |u Hospital Clínico Universitario Lozano Blesa, Department of Gynecology, Saragossa, Spain (GRID:grid.411050.1) (ISNI:0000 0004 1767 4212) | |
| 700 | 1 | |a Costa, Laura |u Department of Gynecology, Sabadell, Bacelona, Spain (GRID:grid.411050.1) | |
| 700 | 1 | |a Rodríguez, Maria Jose |u Hospital Universitario Central de Asturias, Department of Gynecology, Asturias, Spain (GRID:grid.411052.3) (ISNI:0000 0001 2176 9028) | |
| 700 | 1 | |a Huguet, Eva |u Hospital Universitari Mutua de Terrasa, Department of Gynecology, Barcelona, Spain (GRID:grid.414875.b) (ISNI:0000 0004 1794 4956) | |
| 700 | 1 | |a Carreras, Manuel |u Hospital de Sant Boi, Department of Gynecology, Barcelona, Spain (GRID:grid.414875.b) | |
| 700 | 1 | |a Castel-Segui, Ana Belen |u Hospital Son Espases, Department of Gynecology, Mallorca, Spain (GRID:grid.411164.7) (ISNI:0000 0004 1796 5984) | |
| 700 | 1 | |a Font-Roig, Maria |u Hospital Santa Caterina, Department of Gynecology, Girona, Spain (GRID:grid.413409.b) | |
| 700 | 1 | |a Royo, Susana |u Hospital General, Department of Gynecology, Valencia, Spain (GRID:grid.106023.6) (ISNI:0000 0004 1770 977X) | |
| 700 | 1 | |a Sarasa, Nuria |u Hospital de Granollers, Department of Gynecology, Barcelona, Spain (GRID:grid.414740.2) (ISNI:0000 0000 8569 3993) | |
| 700 | 1 | |a Candas, Beatriz |u IDIBELL, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (GRID:grid.418284.3) (ISNI:0000 0004 0427 2257); Hospital Universitari Bellvitge, Hospitalet de Llobregat, Department of Biochemistry and Molecular Biology, Clinical Laboratory, Barcelona, Spain (GRID:grid.411129.e) (ISNI:0000 0000 8836 0780) | |
| 700 | 1 | |a Perez-Carton, Samuel |u Hospital Universitari Bellvitge, Universitat de Barcelona, , Hospitalet de Llobregat, Bellvitge Hospital, Department of Gynecology, Facultat de Medicina, Barcelona, Spain (GRID:grid.411129.e) (ISNI:0000 0000 8836 0780); IDIBELL, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (GRID:grid.418284.3) (ISNI:0000 0004 0427 2257) | |
| 700 | 1 | |a Ortega, Carlos |u Hospital Universitari Bellvitge, Universitat de Barcelona, , Hospitalet de Llobregat, Bellvitge Hospital, Department of Gynecology, Facultat de Medicina, Barcelona, Spain (GRID:grid.411129.e) (ISNI:0000 0000 8836 0780); IDIBELL, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (GRID:grid.418284.3) (ISNI:0000 0004 0427 2257) | |
| 700 | 1 | |a Pla, Maria Jesus |u Hospital Universitari Bellvitge, Universitat de Barcelona, , Hospitalet de Llobregat, Bellvitge Hospital, Department of Gynecology, Facultat de Medicina, Barcelona, Spain (GRID:grid.411129.e) (ISNI:0000 0000 8836 0780); IDIBELL, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (GRID:grid.418284.3) (ISNI:0000 0004 0427 2257) | |
| 700 | 1 | |a Ponce, Jordi |u Hospital Universitari Bellvitge, Universitat de Barcelona, , Hospitalet de Llobregat, Bellvitge Hospital, Department of Gynecology, Facultat de Medicina, Barcelona, Spain (GRID:grid.411129.e) (ISNI:0000 0000 8836 0780); IDIBELL, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (GRID:grid.418284.3) (ISNI:0000 0004 0427 2257) | |
| 773 | 0 | |t Archives of Gynecology and Obstetrics |g vol. 312, no. 6 (Dec 2025), p. 2199 | |
| 786 | 0 | |d ProQuest |t Health & Medical Collection | |
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