Laparoscopic Therapy of Endometrioma: Sclerotherapy vs Cystectomy in Patients With Unfinished Reproductive Plans

NCT ID: NCT05801523

Last Updated: 2024-05-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-01

Study Completion Date

2025-07-01

Brief Summary

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The aim of this prospective randomized study is to compare laparoscopic sclerotherapy to cystectomy in following: AMH dynamics, endometrioma recurrence, complications, pregnancy rate, assisted reproduction methods success rate, live birth rate

Detailed Description

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Only patients who sign informed consent will be included. Only patients wishing for future pregnancy will be involved in the study. Expected number of enrolled subjects is 160 ( 80 in each arm) Patients with endometrioma and planned surgery to remove it will be randomized either to laparoscopic sclerotherapy with 96% ethanol or cystectomy. First AMH sample will be taken day before surgery. If other endometriosis lesions (deep or superficial) are present, they may be also resected during this surgery.

Ethanol sclerotherapy description: classical laparoscopic approach - small (max1cm) fenestration of endometrioma - aspiration of endometrioma contents- foley catheter insertion- ballon inflation inside of the cyst- instillation with 96% ethanol which is left in the cyst for 10min- aspiration of ethanol and flushing with saline.

Cystectomy: classical laparoscopic approach- large fenestration of endometrioma - aspiration of endometrioma contents- indentification of ovary/ endometrioma tissue and plane between the ovarian capsule and cyst wall is developed using a mix of blunt and sharp dissection - if bleeding is present it is stopped by cautious bipolar coagulation

visit 1 - surgery time (AMH day before surgery, age, BMI, endometriosis extent, gravidity/ parity, endometriosis residue after surgery, pain levels) visit 2- 3 months after surgery : Ultrasound, complications, pregnancy, asissted reproduction, pain levels visit 3+4 - 6/12months after surgery: AMH, Ultrasound, complications, pregnancy, asissted reproduction, pain levels visit 5- 24 months after surgery: Ultrasound, complications, pregnancy, asissted reproduction, pain levels

Conditions

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Endometrioma Endometriosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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laparoscopic ethanol sclerotherapy

Group Type ACTIVE_COMPARATOR

laparoscopic ethanol sclerotherapy

Intervention Type PROCEDURE

ethanol (96%) sclerapy of endometrioma - endometrioma is filled with ethanol via foley catether, left for 10 min and than aspirated, endometrioma is washed with saline

laparoscopic cystectomy

Group Type ACTIVE_COMPARATOR

laparoscopic cystectomy of endometrioma

Intervention Type PROCEDURE

cystectomy of endometrioma - removal of endometrioma from ovary surgically

Interventions

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laparoscopic ethanol sclerotherapy

ethanol (96%) sclerapy of endometrioma - endometrioma is filled with ethanol via foley catether, left for 10 min and than aspirated, endometrioma is washed with saline

Intervention Type PROCEDURE

laparoscopic cystectomy of endometrioma

cystectomy of endometrioma - removal of endometrioma from ovary surgically

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* IOTA benign endometrioma
* bilateral or unilateral endometrioma measuring 30 or more milimeters
* patients with unfinished reproductive plans

Exclusion Criteria

* bilateral recurrence of endometrioma
* recurrent endometrioma if the other ovary is not present or patient had cystectomy on the other ovary
* suspision for ovarian malignancy
* signs of inflammatory pelvic disease
* disagreement with participation in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University Hospital Ostrava

OTHER

Sponsor Role collaborator

Institute for the Care of Mother and Child, Prague, Czech Republic

OTHER

Sponsor Role lead

Responsible Party

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Katarina Ivankova

Medical doctor at Endometriosis centre, Institute for the mother and child care

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Katarína Ivánková, MUDr.

Role: PRINCIPAL_INVESTIGATOR

Institute for the Care of Mother and Child, Prague, Czech Republic

Locations

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Institute for mother and child care

Prague, , Czechia

Site Status RECRUITING

Countries

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Czechia

Central Contacts

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Katarína Ivánková

Role: CONTACT

+420 296511200

Facility Contacts

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Katarína Ivánková, MUDr.

Role: primary

References

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Falcone T, Flyckt R. Clinical Management of Endometriosis. Obstet Gynecol. 2018 Mar;131(3):557-571. doi: 10.1097/AOG.0000000000002469.

Reference Type BACKGROUND
PMID: 29420391 (View on PubMed)

Busacca M, Vignali M. Ovarian endometriosis: from pathogenesis to surgical treatment. Curr Opin Obstet Gynecol. 2003 Aug;15(4):321-6. doi: 10.1097/01.gco.0000084247.09900.4f.

Reference Type BACKGROUND
PMID: 12858105 (View on PubMed)

Cohen A, Almog B, Tulandi T. Sclerotherapy in the management of ovarian endometrioma: systematic review and meta-analysis. Fertil Steril. 2017 Jul;108(1):117-124.e5. doi: 10.1016/j.fertnstert.2017.05.015. Epub 2017 Jun 1.

Reference Type BACKGROUND
PMID: 28579409 (View on PubMed)

Kasapoglu I, Ata B, Uyaniklar O, Seyhan A, Orhan A, Yildiz Oguz S, Uncu G. Endometrioma-related reduction in ovarian reserve (ERROR): a prospective longitudinal study. Fertil Steril. 2018 Jul 1;110(1):122-127. doi: 10.1016/j.fertnstert.2018.03.015. Epub 2018 Jun 20.

Reference Type BACKGROUND
PMID: 29935810 (View on PubMed)

Crestani A, Merlot B, Dennis T, Chanavaz-Lacheray I, Roman H. Impact of Laparoscopic Sclerotherapy for Ovarian Endometriomas on Ovarian Reserve. J Minim Invasive Gynecol. 2023 Jan;30(1):32-38. doi: 10.1016/j.jmig.2022.10.001. Epub 2022 Oct 10.

Reference Type BACKGROUND
PMID: 36228863 (View on PubMed)

De Cicco Nardone A, Carfagna P, De Cicco Nardone C, Scambia G, Marana R, De Cicco Nardone F. Laparoscopic Ethanol Sclerotherapy for Ovarian Endometriomas: Preliminary Results. J Minim Invasive Gynecol. 2020 Sep-Oct;27(6):1331-1336. doi: 10.1016/j.jmig.2019.09.792. Epub 2020 May 5.

Reference Type BACKGROUND
PMID: 32380241 (View on PubMed)

Benaglia L, Somigliana E, Vercellini P, Abbiati A, Ragni G, Fedele L. Endometriotic ovarian cysts negatively affect the rate of spontaneous ovulation. Hum Reprod. 2009 Sep;24(9):2183-6. doi: 10.1093/humrep/dep202. Epub 2009 Jun 5.

Reference Type BACKGROUND
PMID: 19502358 (View on PubMed)

Benaglia L, Somigliana E, Vighi V, Ragni G, Vercellini P, Fedele L. Rate of severe ovarian damage following surgery for endometriomas. Hum Reprod. 2010 Mar;25(3):678-82. doi: 10.1093/humrep/dep464. Epub 2010 Jan 17.

Reference Type BACKGROUND
PMID: 20083485 (View on PubMed)

Jee BC. Efficacy of ablation and sclerotherapy for the management of ovarian endometrioma: A narrative review. Clin Exp Reprod Med. 2022 Jun;49(2):76-86. doi: 10.5653/cerm.2021.05183. Epub 2022 May 4.

Reference Type BACKGROUND
PMID: 35698769 (View on PubMed)

Giampaolino P, Bifulco G, Di Spiezio Sardo A, Mercorio A, Bruzzese D, Di Carlo C. Endometrioma size is a relevant factor in selection of the most appropriate surgical technique: a prospective randomized preliminary study. Eur J Obstet Gynecol Reprod Biol. 2015 Dec;195:88-93. doi: 10.1016/j.ejogrb.2015.09.046. Epub 2015 Oct 24.

Reference Type BACKGROUND
PMID: 26492167 (View on PubMed)

Garcia-Tejedor A, Martinez-Garcia JM, Candas B, Suarez E, Manalich L, Gomez M, Merino E, Castellarnau M, Regueiro P, Carreras M, Martinez-Franco E, Carrarrach M, Subirats N, Barbera J, Gonzalez S, Climent M, Fernandez-Montoli E, Ponce J. Ethanol Sclerotherapy versus Laparoscopic Surgery for Endometrioma Treatment: A Prospective, Multicenter, Cohort Pilot Study. J Minim Invasive Gynecol. 2020 Jul-Aug;27(5):1133-1140. doi: 10.1016/j.jmig.2019.08.036. Epub 2020 Apr 7.

Reference Type BACKGROUND
PMID: 32272240 (View on PubMed)

Aflatoonian A, Tabibnejad N. Aspiration versus retention ultrasound-guided ethanol sclerotherapy for treating endometrioma: A retrospective cross-sectional study. Int J Reprod Biomed. 2020 Nov 22;18(11):935-942. doi: 10.18502/ijrm.v13i11.7960. eCollection 2020 Nov.

Reference Type BACKGROUND
PMID: 33349801 (View on PubMed)

Other Identifiers

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AMHstudy

Identifier Type: -

Identifier Source: org_study_id

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