{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:48:30Z","timestamp":1789055310153,"version":"build-2803163510"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Fundaci\u00f3 Instituci\u00f3 dels Centres de Recerca de Catalunya"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the efficacy of ultrasound-guided alcohol sclerotherapy versus laparoscopic cystectomy for the management of ovarian endometriomas, focusing on complications, recurrence, pain relief, and healthcare costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a multicentre, randomized clinical trial across 20 centers in Spain. A total of 167 women aged 18\u201340\u00a0years with ovarian endometriomas (35\u2013100\u00a0mm) were recruited between June 2018 and June 2022. Participants were randomized to receive either ultrasound-guided aspiration with ethanol sclerotherapy or standard laparoscopic cystectomy. Complications were graded using the Clavien\u2013Dindo classification. Pain was assessed using a visual analogue scale (VAS) before and six months after treatment. Recurrence was defined as the reappearance of a cystic lesion at the treated site and analyzed using Kaplan\u2013Meier curves and log-rank tests. The primary analysis followed an\n                      <jats:italic>intention-to-treat<\/jats:italic>\n                      approach and included 158 patients (sclerotherapy:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200984; cystectomy:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200974). The\n                      <jats:italic>per-protocol<\/jats:italic>\n                      analysis included 92 patients (sclerotherapy:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200957; cystectomy:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200937). Direct hospital costs, complication rates, recurrence, and pain relief were compared between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intention-to-treat analyses show that complications were low in both groups (12%), most of which were Grade I\u2013II, although 4.1% were Grade III in the surgery group. The cost of sclerotherapy was significantly lower (\u20ac472 vs. \u20ac2128,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In per-protocol analyses, the cyst recurrence or reappearance was similar between the two groups, with rates of 25.7% (9 of 35) in the surgery group and 22.8% (13 of 57) in the sclerotherapy group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.16). Pain was improved or completely resolved in 49 of 55 cases (89.1%) in the sclerotherapy group and in 21 of 32 cases (65.7%) in the laparoscopic surgery group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Ultrasound-guided alcohol sclerotherapy is a safe, cost-effective alternative to laparoscopic cystectomy for the treatment of endometriomas, with comparable recurrence rates and pain relief. Clinical Trial Registration:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/search?term=NCT03571776\" ext-link-type=\"uri\">https:\/\/clinicaltrials.gov\/search?term=NCT03571776<\/jats:ext-link>\n                      . Registered May 5, 2018.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-025-08205-1","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T05:27:10Z","timestamp":1762234030000},"page":"2199-2210","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ultrasound-guided ethanol sclerotherapy versus laparoscopic surgery for endometriomas: a randomized clinical trial in a real-world setting"],"prefix":"10.1007","volume":"312","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3398-0570","authenticated-orcid":false,"given":"Amparo","family":"Garc\u00eda-Tejedor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Guevara-Peralta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Manuel","family":"Martinez-Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiana","family":"Corbal\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Ag\u00fcero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gomez-Romero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Cararach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Castellarnau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariv\u00ed","family":"Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cristina","family":"Lou-Mercad\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jose","family":"Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Huguet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Carreras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Belen","family":"Castel-Segui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Font-Roig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Royo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Sarasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Candas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Perez-Carton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Ortega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jesus","family":"Pla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Ponce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"issue":"5","key":"8205_CR1","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1159\/000452660","volume":"82","author":"MJ Fuldeore","year":"2017","unstructured":"Fuldeore MJ, Soliman AM (2017) Prevalence and symptomatic burden of diagnosed endometriosis in the United States: national estimates from a cross-sectional survey of 59,411 women. 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Amparo Garc\u00eda-Tejedor receives congress support from Italfarmaco SA and Corza medical for the endometriosis curse organisation and speaking in 2024; Ana C Lou from Gedeon and Theramex SA, Marivi Rodriguez also from MERCK SA. Susana Royo receives master funding support from SERONO SA. The authors alone are responsible for the content and writing of the paper. The preliminary results of this study were presented as an oral presentation at the XVI International Course of Gynecologic Surgery in 2019 in Barcelona, Spain, and in the form of an abstract at the 6th European Congress on Endometriosis in Bordeaux, France from June 15 to 17th, 2022.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Institutional Review Board of our hospital on February 8, 2018 (reference PR031\/18).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}