Ghasemi Tehrani Hatav, Tavakoli Raheleh, Hashemi Maryam, Haghighat Somayeh
Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Physiology Research Centre, Kashan University of Medical Sciences, Isfahan, Iran.
Arch Acad Emerg Med. 2022 Jul 7;10(1):e55. doi: 10.22037/aaem.v10i1.1636. eCollection 2022.
A variety of therapeutic modalities are available in management of ovarian endometrioma. This study aimed to compare the effects of ethanol sclerotherapy and laparoscopic surgery on disease recurrence and ovarian factors of these patients.
70 women with ovarian endometrioma and chronic pelvic pain were randomly divided into two groups. The first group underwent sclerotherapy with a puncture needle (cook) and the second group underwent laparoscopic surgery. Both groups were followed up every three months to investigate the recurrence rate. In this regard, ultrasonography was performed 3 months and 12 months after treatment, and serum anti-Müllerian hormone (AMH) levels were also reassessed 12 weeks after the intervention.
70 women with the mean age of 31.46 ± 4.71 years, and the mean body mass index (BMI) of 23.12 ± 1.01 were studied. The two groups were similar regarding age (p = 0.770), BMI (p = 0.371), history of gastrointestinal signs (p = 0.794), history of urinary diseases (p = 0.324), dysmenorrhea (p = 0.403), pelvic pain (p = 0.454), dyspareunia (p = 0.448), location of cyst (p = 0.448), and diameter of cyst (p = 0.250). In the laparoscopic group, a significant decrease in anti-Müllerian hormone (AMH) levels was observed after 12 weeks (p < 0.0001), while in the sclerotherapy group, no significant changes were found between pre-and post-operative AMH levels (p = 0.120). Cyst size decreased significantly in both groups three months (p < 0.001) and twelve months (p < 0.0001) after treatment. In the third month, 8 patients in the sclerotherapy group and 13 patients in the laparoscopic group had recurrences, and in the twelfth month, 17 patients in the sclerotherapy group and 15 patients in the laparoscopic group had recurrence of symptoms (p > 0.05).
Although AMH level and mean cyst diameter were significantly lower one year after laparoscopy, recurrence rate of ovarian endometrioma was similar between ethanol sclerotherapy and laparoscopy methods.
卵巢子宫内膜异位囊肿的治疗有多种方式。本研究旨在比较乙醇硬化治疗和腹腔镜手术对这些患者疾病复发及卵巢相关因素的影响。
70例患有卵巢子宫内膜异位囊肿及慢性盆腔疼痛的女性被随机分为两组。第一组采用穿刺针（库克）进行硬化治疗，第二组接受腹腔镜手术。两组均每三个月随访一次以调查复发率。在这方面，治疗后3个月和12个月进行超声检查，干预后12周也重新评估血清抗苗勒管激素（AMH）水平。
研究了70例平均年龄为31.46±4.71岁、平均体重指数（BMI）为23.12±1.01的女性。两组在年龄（p = 0.770）、BMI（p = 0.371）、胃肠道症状史（p = 0.794）、泌尿系统疾病史（p = 0.324）、痛经（p = 0.403）、盆腔疼痛（p = 0.454）、性交困难（p = 0.448）、囊肿位置（p = 0.448）及囊肿直径（p = 0.250）方面相似。在腹腔镜组，12周后抗苗勒管激素（AMH）水平显著下降（p < 0.0001），而在硬化治疗组，术前和术后AMH水平无显著变化（p = 0.120）。两组治疗后3个月（p < 0.001）和12个月（p < 0.0001）囊肿大小均显著减小。在第三个月，硬化治疗组有8例患者复发，腹腔镜组有13例患者复发；在第十二个月，硬化治疗组有17例患者症状复发，腹腔镜组有15例患者症状复发（p > 0.05）。
虽然腹腔镜术后一年AMH水平和平均囊肿直径显著降低，但乙醇硬化治疗和腹腔镜手术方法治疗卵巢子宫内膜异位囊肿的复发率相似。
