Ultrasound-guided transvaginal ethanol sclerotherapy for ovarian endometrioma in advanced deep infiltrating endometriosis: A case report

Ultrasound-guided transvaginal ethanol sclerotherapy is one of the methods for ovarian endometrioma treatment. It involves aspiration of the cyst content and subsequent administration of some fibrosis agent. This minimally invasive procedure does not reduce ovarian reserve hence, it is addressed to patients with fertility plans. To date, there have been no reports of this method being used in patients with advanced disease stages. Therefore, we present a case of a patient with advanced deep infiltrating endometriosis who underwent this treatment procedure for endometrioma. Our patient had a history of two extensive laparotomies for deep infiltrating endometriosis. A follow-up MRI examination revealed the presence of ovarian endometrioma and disturbed anatomy of the pelvis. The patient was referred to our center and deemed a suitable candidate for ultrasound-guided transvaginal ethanol sclerotherapy for endometrioma. The procedure was successfully performed. After 8 months of follow-up, no recurrences were observed, and the patient reported significant alleviation of pain symptoms. The high efficacy of sclerotherapy in managing advanced endometriosis phenotypes is encouraging. However, further research is needed.