Comparison of the therapeutic efficacy and ovarian reserve between catheter-directed sclerotherapy and surgical excision for ovarian endometrioma

Objectives To compare the efficacies of catheter-directed sclerotherapy (CDS) with 99% ethanol and surgery for ovarian endometrioma and their impact on the ovarian reserve. Methods From January 2011 to June 2019, 71 patients who underwent surgical excision ( n = 51) or CDS ( n = 20) for symptomatic ovarian endometriomas were reviewed. To analyze the effect on the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were compared before and after the procedure. Symptoms, serum cancer antigen 125 (CA-125), lesion size, recurrence, hospitalization, and complications were reviewed retrospectively. Results During a mean follow-up of 22.3 months (range, 6 to 94 months), no significant difference in symptom relief was found between CDS and surgery (95.0% [19/20] and 92.2% [47/51], respectively, p > 0.999). The hospital stay was shorter with CDS than with surgery (2.6 ± 0.6 days and 4.1 ± 0.5 days, respectively, p