Abstract No. 573 Safety and Clinical Outcomes of Two-Session Catheter-Directed Sclerotherapy Using Ethanol for Endometrioma

To evaluate the safety and clinical outcome of two-session catheter-directed sclerotherapy (CDS) with 96% ethanol in patients with endometrioma. Eighteen patients (mean age, 31.3 years; range, 23–41 years) with ovarian endometrioma receiving two sessions of CDS under ultrasound guidance between June 2020 and October 2022 were prospectively evaluated. The catheter was retained in situ for the second session the next day. Serum anti-Müllerian hormone (AMH) was measured before and 6 months after CDS to assess ovarian reserve. The cyst volume was measured on ultrasound before and 1, 3, and 6 months after CDS, and the volume reduction ratio was calculated to reveal the changes in the volume. A total of 26 endometriomas in 18 patients were treated; 23 endometriomas were successfully treated with two-session CDS, while one session was incomplete in three patients due to contrast leakage. Minor procedure-related complications developed in four patients and resolved spontaneously before discharge on the same day of the second session. No recurrence was identified during follow-up. The mean endometrioma diameter decreased from 5.5 ± 1.7 cm to 1.4 ± 0.9 cm at the 6-month follow-up (P < 0.001). The serum AMH level was lowered but did not significantly differ at 6 months from the baseline (1.67 ± 1.44 ng/mL vs. 1.16 ± 0.96 ng/mL; P = 0.161). Volume reduction ratios at 1, 3, and 6 months after CDS were 87.4 ± 11.6%, 95.8 ± 5. 1%, and 96.7 ± 4.4%, respectively. Two-session CDS with 96% ethanol is safe, feasible, and effective for treating endometrioma with the ovarian function well preserved.