DOI QR코드

DOI QR Code

Efficacy of ablation and sclerotherapy for the management of ovarian endometrioma: A narrative review

  • Jee, Byung Chul (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital)
  • 투고 : 2021.12.23
  • 심사 : 2022.02.23
  • 발행 : 2022.06.30

초록

Ovarian cystectomy is the preferred technique for the surgical management of ovarian endometrioma. However, other techniques such as ablation or sclerotherapy are also commonly used. The aim of this review is to summarize information regarding the efficacy of ablation and sclerotherapy compared to cystectomy in terms of ovarian reserve, the recurrence rate, and the pregnancy rate. Several studies comparing ablation versus cystectomy or sclerotherapy versus cystectomy in terms of the serum anti-Müllerian hormone (AMH) decrement, endometrioma recurrence, or the pregnancy rate were identified and summarized. Both ablation and cystectomy have a negative impact on ovarian reserve, but ablation results in a smaller serum AMH decrement than cystectomy. Nonetheless, the recurrence rate is higher after ablation than after cystectomy. More studies are needed to demonstrate whether the pregnancy rate is different according to whether patients undergo ablation or cystectomy. The evidence remains inconclusive regarding whether sclerotherapy is better than cystectomy in terms of ovarian reserve. The recurrence rates appear to be similar between sclerotherapy and cystectomy. There is not yet concrete evidence that sclerotherapy helps to improve the pregnancy rate via in vitro fertilization in comparison to cystectomy or no sclerotherapy.

키워드

참고문헌

  1. Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril 1997;68:585-96. https://doi.org/10.1016/S0015-0282(97)00191-X
  2. Busacca M, Vignali M. Ovarian endometriosis: from pathogenesis to surgical treatment. Curr Opin Obstet Gynecol 2003;15:321-6. https://doi.org/10.1097/01.gco.0000084247.09900.4f
  3. Lee HJ, Park YM, Jee BC, Kim YB, Suh CS. Various anatomic locations of surgically proven endometriosis: a single-center experience. Obstet Gynecol Sci 2015;58:53-8. https://doi.org/10.5468/ogs.2015.58.1.53
  4. Hart RJ, Hickey M, Maouris P, Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev 2008;(2):CD004992.
  5. Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D'Hooghe T, De Bie B, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod 2014;29:400-12. https://doi.org/10.1093/humrep/det457
  6. Younis JS, Shapso N, Fleming R, Ben-Shlomo I, Izhaki I. Impact of unilateral versus bilateral ovarian endometriotic cystectomy on ovarian reserve: a systematic review and meta-analysis. Hum Reprod Update 2019;25:375-91. https://doi.org/10.1093/humupd/dmy049
  7. Sanchez AM, Vigano P, Somigliana E, Panina-Bordignon P, Vercellini P, Candiani M. The distinguishing cellular and molecular features of the endometriotic ovarian cyst: from pathophysiology to the potential endometrioma-mediated damage to the ovary. Hum Reprod Update 2014;20:217-30. https://doi.org/10.1093/humupd/dmt053
  8. Giampaolino P, Bifulco G, Di Spiezio Sardo A, Mercorio A, Bruzzese D, Di Carlo C. Endometrioma size is a relevant factor in selection of the most appropriate surgical technique: a prospective randomized preliminary study. Eur J Obstet Gynecol Reprod Biol 2015;195:88-93. https://doi.org/10.1016/j.ejogrb.2015.09.046
  9. Kim YJ, Cha SW, Kim HO. Serum anti-Mullerian hormone levels decrease after endometriosis surgery. J Obstet Gynaecol 2017;37: 342-6. https://doi.org/10.1080/01443615.2016.1239071
  10. Saito N, Yamashita Y, Okuda K, Kokunai K, Terai Y, Ohmichi M. Comparison of the impact of laparoscopic endometriotic cystectomy and vaporization on postoperative serum anti-Mullerian hormone levels. Asian J Endosc Surg 2018;11:23-29. https://doi.org/10.1111/ases.12412
  11. Pais AS, Flagothier C, Tebache L, Almeida Santos T, Nisolle M. Impact of surgical management of endometrioma on AMH levels and pregnancy rates: a review of recent literature. J Clin Med 2021;10:414. https://doi.org/10.3390/jcm10030414
  12. Baracat CM, Abdalla-Ribeiro HS, Araujo RS, Bernando WM, Ribeiro PA. The impact on ovarian reserve of different hemostasis methods in laparoscopic cystectomy: a systematic review and meta-analysis. Rev Bras Ginecol Obstet 2019;41:400-8. https://doi.org/10.1055/s-0039-1692697
  13. Song T, Lee SH, Kim WY. Additional benefit of hemostatic sealant in preservation of ovarian reserve during laparoscopic ovarian cystectomy: a multi-center, randomized controlled trial. Hum Reprod 2014;29:1659-65. https://doi.org/10.1093/humrep/deu125
  14. Sahin C, Akdemir A, Ergenoglu AM, Ozgurel B, Yeniel AO, Taskiran D, et al. Which should be the preferred technique during laparoscopic ovarian cystectomy. Reprod Sci 2017;24:393-9. https://doi.org/10.1177/1933719116657195
  15. Xiao J, Zhou J, Liang H, Liu F, Xu C, Liang L. Impact of hemostatic methods on ovarian reserve and fertility in laparoscopic ovarian cystectomy. Exp Ther Med 2019;17:2689-93.
  16. Kang JH, Kim YS, Lee SH, Kim WY. Comparison of hemostatic sealants on ovarian reserve during laparoscopic ovarian cystectomy. Eur J Obstet Gynecol Reprod Biol 2015;194:64-7. https://doi.org/10.1016/j.ejogrb.2015.08.010
  17. Ferrero S, Venturini PL, Gillott DJ, Remorgida V, Leone Roberti Maggiore U. Hemostasis by bipolar coagulation versus suture after surgical stripping of bilateral ovarian endometriomas: a randomized controlled trial. J Minim Invasive Gynecol 2012;19:722-30. https://doi.org/10.1016/j.jmig.2012.08.001
  18. Takashima A, Takeshita N, Otaka K, Kinoshita T. Effects of bipolar electrocoagulation versus suture after laparoscopic excision of ovarian endometrioma on the ovarian reserve and outcome of in vitro fertilization. J Obstet Gynaecol Res 2013;39:1246-52. https://doi.org/10.1111/jog.12056
  19. Tanprasertkul C, Ekarattanawong S, Sreshthaputra O, Vutyavanich T. Impact of hemostasis methods, electrocoagulation versus suture, in laparoscopic endometriotic cystectomy on the ovarian reserve: a randomized controlled trial. J Med Assoc Thai 2014;97 Suppl 8:S95-101.
  20. Asgari Z, Rouholamin S, Hosseini R, Sepidarkish M, Hafizi L, Javaheri A. Comparing ovarian reserve after laparoscopic excision of endometriotic cysts and hemostasis achieved either by bipolar coagulation or suturing: a randomized clinical trial. Arch Gynecol Obstet 2016;293:1015-22. https://doi.org/10.1007/s00404-015-3918-4
  21. Zhang CH, Wu L, Li PQ. Clinical study of the impact on ovarian reserve by different hemostasis methods in laparoscopic cystectomy for ovarian endometrioma. Taiwan J Obstet Gynecol 2016;55: 507-11. https://doi.org/10.1016/j.tjog.2015.08.026
  22. Sonmezer M, Taskin S, Gemici A, Kahraman K, Ozmen B, Berker B, et al. Can ovarian damage be reduced using hemostatic matrix during laparoscopic endometrioma surgery? A prospective, randomized study. Arch Gynecol Obstet 2013;287:1251-7. https://doi.org/10.1007/s00404-012-2704-9
  23. Chung J, Law T, Chung C, Mak J, Sahota DS, Li TC. Impact of haemostatic sealant versus electrocoagulation on ovarian reserve after laparoscopic ovarian cystectomy of ovarian endometriomas: a randomised controlled trial. BJOG 2019;126:1267-75. https://doi.org/10.1111/1471-0528.15807
  24. Araujo RS, Maia SB, Baracat CM, Fernandes CQ, Ribeiro HS, Ribeiro PA. Ovarian function following use of various hemostatic techniques during treatment for unilateral endometrioma: a randomized controlled trial. Int J Gynaecol Obstet 2021 Sep 3 [Epub]. https://doi.org/10.1002/ijgo.13912.
  25. Song T, Kim WY, Lee KW, Kim KH. Effect on ovarian reserve of hemostasis by bipolar coagulation versus suture during laparoendoscopic single-site cystectomy for ovarian endometriomas. J Minim Invasive Gynecol 2015;22:415-20. https://doi.org/10.1016/j.jmig.2014.11.002
  26. Choi C, Kim WY, Lee DH, Lee SH. Usefulness of hemostatic sealants for minimizing ovarian damage during laparoscopic cystectomy for endometriosis. J Obstet Gynaecol Res 2018;44:532-9. https://doi.org/10.1111/jog.13542
  27. Deckers P, Ribeiro SC, Simoes RD, Miyahara CB, Baracat EC. Systematic review and meta-analysis of the effect of bipolar electrocoagulation during laparoscopic ovarian endometrioma stripping on ovarian reserve. Int J GynaecolObstet 2018;140:11-7.
  28. Working group of ESGE; ESHRE and WES, Saridogan E, Becker CM, Feki A, Grimbizis GF, et al. Recommendations for the surgical treatment of endometriosis. Part 1: ovarian endometrioma. Hum Reprod Open 2017;2017:hox016. https://doi.org/10.1093/hropen/hox016
  29. Carmona F, Martinez-Zamora MA, Rabanal A, Martinez-Roman S, Balasch J. Ovarian cystectomy versus laser vaporization in the treatment of ovarian endometriomas: a randomized clinical trial with a five-year follow-up. Fertil Steril 2011;96:251-4. https://doi.org/10.1016/j.fertnstert.2011.04.068
  30. Candiani M, Ottolina J, Posadzka E, Ferrari S, Castellano LM, Tandoi I, et al. Assessment of ovarian reserve after cystectomy versus 'one-step' laser vaporization in the treatment of ovarian endometrioma: a small randomized clinical trial. Hum Reprod 2018;33: 2205-11. https://doi.org/10.1093/humrep/dey305
  31. Candiani M, Ottolina J, Schimberni M, Tandoi I, Bartiromo L, Ferrari S. Recurrence rate after "One-step" CO2 fiber laser vaporization versus cystectomy for ovarian endometrioma: a 3-year follow-up study. J Minim Invasive Gynecol 2020;27:901-8. https://doi.org/10.1016/j.jmig.2019.07.027
  32. Mircea O, Puscasiu L, Resch B, Lucas J, Collinet P, von Theobald P, et al. Fertility outcomes after ablation using plasma energy versus cystectomy in infertile women with ovarian endometrioma: a multicentric comparative study. J Minim Invasive Gynecol 2016; 23:1138-45. https://doi.org/10.1016/j.jmig.2016.08.818
  33. Shaltout MF, Elsheikhah A, Maged AM, Elsherbini MM, Zaki SS, Dahab S, et al. A randomized controlled trial of a new technique for laparoscopic management of ovarian endometriosis preventing recurrence and keeping ovarian reserve. J Ovarian Res 2019;12:66. https://doi.org/10.1186/s13048-019-0542-0
  34. Chen J, Huang D, Zhang J, Shi L, Li J, Zhang S. The effect of laparoscopic excisional and ablative surgery on ovarian reserve in patients with endometriomas: a retrospective study. Medicine (Baltimore) 2021;100:e24362. https://doi.org/10.1097/MD.0000000000024362
  35. Beretta P, Franchi M, Ghezzi F, Busacca M, Zupi E, Bolis P. Randomized clinical trial of two laparoscopic treatments of endometriomas: cystectomy versus drainage and coagulation. Fertil Steril 1998;70:1176-80. https://doi.org/10.1016/S0015-0282(98)00385-9
  36. Alborzi S, Momtahan M, Parsanezhad ME, Dehbashi S, Zolghadri J, Alborzi S. A prospective, randomized study comparing laparoscopic ovarian cystectomy versus fenestration and coagulation in patients with endometriomas. Fertil Steril 2004;82:1633-7. https://doi.org/10.1016/j.fertnstert.2004.04.067
  37. Alborzi S, Ravanbakhsh R, Parsanezhad ME, Alborzi M, Alborzi S, Dehbashi S. A comparison of follicular response of ovaries to ovulation induction after laparoscopic ovarian cystectomy or fenestration and coagulation versus normal ovaries in patients with endometrioma. Fertil Steril 2007;88:507-9. https://doi.org/10.1016/j.fertnstert.2006.11.134
  38. Donnez J, Lousse JC, Jadoul P, Donnez O, Squifflet J. Laparoscopic management of endometriomas using a combined technique of excisional (cystectomy) and ablative surgery. Fertil Steril 2010;94:28-32. https://doi.org/10.1016/j.fertnstert.2009.02.065
  39. Muzii L, Achilli C, Bergamini V, Candiani M, Garavaglia E, Lazzeri L, et al. Comparison between the stripping technique and the combined excisional/ablative technique for the treatment of bilateral ovarian endometriomas: a multicentre RCT. Hum Reprod 2016; 31:339-44. https://doi.org/10.1093/humrep/dev313
  40. Pados G, Tsolakidis D, Assimakopoulos E, Athanatos D, Tarlatzis B. Sonographic changes after laparoscopic cystectomy compared with three-stage management in patients with ovarian endometriomas: a prospective randomized study. Hum Reprod 2010;25: 672-7. https://doi.org/10.1093/humrep/dep448
  41. Tsolakidis D, Pados G, Vavilis D, Athanatos D, Tsalikis T, Giannakou A, et al. The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study. Fertil Steril 2010;94:71-7. https://doi.org/10.1016/j.fertnstert.2009.01.138
  42. Noma J, Yoshida N. Efficacy of ethanol sclerotherapy for ovarian endometriomas. Int J Gynaecol Obstet 2001;72:35-9. https://doi.org/10.1016/S0020-7292(00)00307-6
  43. Hsieh CL, Shiau CS, Lo LM, Hsieh TT, Chang MY. Effectiveness of ultrasound-guided aspiration and sclerotherapy with 95% ethanol for treatment of recurrent ovarian endometriomas. Fertil Steril 2009;91:2709-13. https://doi.org/10.1016/j.fertnstert.2008.03.056
  44. Wang LL, Dong XQ, Shao XH, Wang SM. Ultrasound-guided interventional therapy for recurrent ovarian chocolate cysts. Ultrasound Med Biol 2011;37:1596-602. https://doi.org/10.1016/j.ultrasmedbio.2011.07.004
  45. Aflatoonian A, Tabibnejad N. Aspiration versus retention ultrasound-guided ethanol sclerotherapy for treating endometrioma: a retrospective cross-sectional study. Int J Reprod Biomed 2020;18:935-42.
  46. Huang L, Chang MY, Shiau CS, Hsieh TT. Changes in anti-mullerian hormone after ultrasound guided aspiration and ethanol sclerotic therapy of ovarian cyst. Taiwan J Obstet Gynecol 2021;60:509-12. https://doi.org/10.1016/j.tjog.2021.03.021
  47. Han K, Seo SK, Kim MD, Kim GM, Kwon JH, Kim HJ, et al. Catheter-directed sclerotherapy for ovarian endometrioma: short-term outcomes. Radiology 2018;289:854-9. https://doi.org/10.1148/radiol.2018180606
  48. Chan LY, So WW, Lao TT. Rapid recurrence of endometrioma after transvaginal ultrasound-guided aspiration. Eur J Obstet Gynecol Reprod Biol 2003;109:196-8. https://doi.org/10.1016/S0301-2115(03)00011-3
  49. Zhu W, Tan Z, Fu Z, Li X, Chen X, Zhou Y. Repeat transvaginal ultrasound-guided aspiration of ovarian endometrioma in infertile women with endometriosis. Am J Obstet Gynecol 2011;204:61. e1-6.
  50. Yazbeck C, Madelenat P, Ayel JP, Jacquesson L, Bontoux LM, Solal P, et al. Ethanol sclerotherapy: a treatment option for ovarian endometriomas before ovarian stimulation. Reprod Biomed Online 2009;19:121-5. https://doi.org/10.1016/S1472-6483(10)60055-7
  51. Aflatoonian A, Rahmani E, Rahsepar M. Assessing the efficacy of aspiration and ethanol injection in recurrent endometrioma before IVF cycle: a randomized clinical trial. Iran J Reprod Med 2013;11:179-84.
  52. Lee KH, Kim CH, Lee YJ, Kim SH, Chae HD, Kang BM. Surgical resection or aspiration with ethanol sclerotherapy of endometrioma before in vitro fertilization in infertilie women with endometrioma. Obstet Gynecol Sci 2014;57:297-303. https://doi.org/10.5468/ogs.2014.57.4.297
  53. Miquel L, Preaubert L, Gnisci A, Resseguier N, Pivano A, Perrin J, et al. Endometrioma ethanol sclerotherapy could increase IVF live birth rate in women with moderate-severe endometriosis. PLoS One 2020;15:e0239846. https://doi.org/10.1371/journal.pone.0239846
  54. Alborzi S, Askary E, Keramati P, Moradi Alamdarloo S, Poordast T, Ashraf MA, et al. Assisted reproductive technique outcomes in patients with endometrioma undergoing sclerotherapy vs laparoscopic cystectomy: prospective cross-sectional study. Reprod Med Biol 2021;20:313-20. https://doi.org/10.1002/rmb2.12386
  55. Garcia-Tejedor A, Martinez-Garcia JM, Candas B, Suarez E, Manalich L, Gomez M, et al. Ethanol sclerotherapy versus laparoscopic surgery for endometrioma treatment: a prospective, multicenter, cohort pilot study. J Minim Invasive Gynecol 2020;27:1133-40. https://doi.org/10.1016/j.jmig.2019.08.036
  56. Koo JH, Lee I, Han K, Seo SK, Kim MD, Lee JK, et al. Comparison of the therapeutic efficacy and ovarian reserve between catheter-directed sclerotherapy and surgical excision for ovarian endometrioma. Eur Radiol 2021;31:543-8. https://doi.org/10.1007/s00330-020-07111-1