Endometrioma Sclerotherapy and Ovarian Preservation
Research type
Research Study
Full title
Endometrioma sclerotherapy and ovarian preservation: a randomised control trial of laparoscopic sclerotherapy vs traditional excision of endometrioma
IRAS ID
319304
Contact name
Mark Johnson
Contact email
Sponsor organisation
Chelsea and Westminster Hospital NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Ovarian cysts due to endometriosis (endometriomata) are formed when menstrual like fluid accumulates inside the ovary and affect 40% of those with endometriosis. They do not regress spontaneously and cause subfertility by a number of mechanisms: inflammatory cyst fluid reduces egg quality and distortion of the ovary prevents access and damages eggs retrieved during IVF.
Hormonal therapy can improve symptoms, however, is not useful in those wanting conception. Standard treatment is excision of the cyst by key-hole surgery, however this causes collateral damage to the surrounding tissue, reducing ovarian reserve by 30%. This increases to 45% if cysts are large or bilateral, such that these cases are often treated in two stages, surgery for cyst drainage followed by removal at a second procedure, limiting collateral damage.
Alcohol sclerotherapy is a technique for treating endometriomata, involving cyst drainage and filling with alcohol to destroy the endometriosis within. It can be performed under ultrasound as an outpatient procedure, or at the time of surgery under direct vision. The technique is safe and effective at treating the cysts and importantly maintains ovarian reserve. The recurrence rates may be higher with sclerotherapy under ultrasound guidance than after excision of endometrioma. Surgery in these cases is required for treatment of concomitant endometriosis and investigation of Fallopian tubes.
We hypothesise that alcohol sclerotherapy performed laparoscopically under direct surgical visualisation in those patients who would normally have a single stage surgical approach has a comparative effect on symptom improvement and recurrence when compared with standard laparoscopic excision of endometrioma whilst maintaining ovarian reserve.
REC name
London - Surrey Research Ethics Committee
REC reference
24/LO/0825
Date of REC Opinion
10 Dec 2024
REC opinion
Further Information Favourable Opinion