Techniques and Clinical Outcomes of Catheter-Directed Sclerotherapy Using Ethanol for Ovarian Endometriomas

Although medical therapies and surgical cystectomy are common treatments for ovarian endometriomas, recurrence and ovarian reserve decline remain concerns. Catheter-directed sclerotherapy is a promising alternative because the use of large-bore catheter allows improved cyst content aspiration, making sclerotherapy more effective. The procedure is typically performed transvaginally, and transabdominal access is considered when transvaginal access is not applicable. According to previous reports, this technique demonstrates high technical success and results in a meaningful reduction in cyst volume and better preservation of the ovarian reserve compared with surgery. Recurrence rates also tend to be lower. This pictorial essay presents the catheter-directed sclerotherapy technique and typical cases using this technique, both transvaginally and transabdominally.