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The decision to apply which sclerotherapy technique was made during the procedure for each patient considering the following factors: cyst size, cyst location, cyst viscosity, and tissue rigidity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Both needle-directed (<jats:italic>n<\/jats:italic>\u2009=\u200934 cysts) and catheter-directed (<jats:italic>n<\/jats:italic>\u2009=\u200934 cysts) sclerotherapy techniques were effective, with a 100% technical success rate and a 97% clinical success rate. In two of 34 cysts (6%) treated with needle-directed sclerotherapy, recurrence was detected and successfully retreated with catheter-directed sclerotherapy. Significant reductions in cyst size, pain, and serum cancer antigen 125 levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) were noted. Serum anti-M\u00fcllerian hormone levels remained unaffected, indicating preserved ovarian reserve (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Among those treated for infertility, the pregnancy rate was 54% (<jats:italic>n<\/jats:italic>\u2009=\u20096\/11). The mean\u2009\u00b1\u2009SD cyst size decline was greater in catheter-directed sclerotherapy than needle-directed sclerotherapy (5.5\u2009\u00b1\u20093.1\u00a0cm vs. 4.0\u2009\u00b1\u20092.1\u00a0cm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). However, the pretreatment cyst volumes were considerably higher in catheter-directed sclerotherapy group (202.0\u2009\u00b1\u2009233.5\u00a0mL vs. 78.8\u2009\u00b1\u200959.7\u00a0mL, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and were associated with significant post-treatment volume decrease (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The choice between catheter-directed and needle-directed ethanol sclerotherapy should be determined during the procedure, with a preference for catheter-directed sclerotherapy when feasible. Crucial factors in making this decision include cyst size, cyst location, cyst viscosity, and tissue rigidity.<\/jats:p>\n                <jats:p>Level of evidence Level 3, non-controlled retrospective cohort study.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00270-024-03694-0","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T15:01:46Z","timestamp":1711724506000},"page":"891-900","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Ethanol Sclerotherapy in the Management of Ovarian Endometrioma: Technical Considerations for Catheter- and Needle-Directed Sclerotherapy"],"prefix":"10.1007","volume":"47","author":[{"given":"Aynur","family":"Azizova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turkmen Turan","family":"Ciftci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Gultekin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Unal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6864-0229","authenticated-orcid":false,"given":"Okan","family":"Akhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurkan","family":"Bozdag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devrim","family":"Akinci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,29]]},"reference":[{"key":"3694_CR1","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1056\/NEJMra0804690","volume":"360","author":"SE Bulun","year":"2009","unstructured":"Bulun SE. 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