Sclerotherapy with Ethanol: An Effective and Safe Alternative to Potentially Complex Surgical Treatment of Recurrent Ovarian Endometrioma
Bibliographic record
Abstract
ABSTRACT Objective The aim of this study was to evaluate the efficacy and safety of transvaginal ultrasound guided aspiration of ovarian endometrioma and ethanol sclerotherapy before controlled ovarian hyperstimulation (COH) and intrauterine insemination (IUI) or assisted reproductive technology (ART) in patients with recurrent ovarian endometrioma. Design Prospective study. Setting Infertility Care and Research Center (ICRC Pvt Ltd.), Dhaka, Bangladesh. Materials and methods Fifty-three patients with infertility and recurrent ovarian endometrioma were the target population of this study. Sclerotherapy was performed under sedation (Pethidine) or G/A (propofol) and transvaginal ultrasound guidance. An 16-guage, double-lumen needle was inserted into the endometrioma and the cyst contents were sequentially aspirated and flushed with sterile saline until the aspirated fluid was clear. Ninety-five percent ethyle alcohol (ethanol) was then instilled into the cyst and kept in situ. Ultrasound was performed 6 weeks, 3, 6 and 12 months later to assess the efficacy of treatment. Controlled ovarian hyperstimulation and IUI or ART was performed according to patients’ profile and desire. Main outcome measures Resolution and recurrence of endometrioma and pregnancy rate. Results Thirty-nine patients had unilateral, 14 had bilateral, 36 had single and 17 had more than one cysts. Size of the cysts were 3.5 to 10 cm, average 6.75 ± 1.64 cm. Complete resolution of cyst took place in 42 (79.25%) cases. Eleven patients had persistence and refilling of cyst. Four of them needed reaspiration. No complications developed in any case. Thirty patients (52 cycles) underwent COH and IUI and 5 (16.57%) of them got pregnant. Forty-one patients underwent ART (63 cycles) and 13 (31.71%) got pregnant. Six (11.32) patients developed small cyst <3 cm within 1 year during the course of treatment. Conclusion Sclerotherapy with 95% ethanol is a simple, effective and safe alternative to surgical intervention for treatment of recurrent ovarian endometriomas before COH and IUI or ART. How to cite this article Begum M R, Ehsan M, Ehsan N, Santa MSB, Khan F, Sharmin F. Sclerotherapy with Ethanol: An Effective and Safe Alternative to Potentially Complex Surgical Treatment of Recurrent Ovarian Endometrioma. J South Asian Feder Obst Gynae 2015;7(2):97-101.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".