Publication:

The first case of ethanol sclerotherapy in 1998. Management of recurrent endometriosis after TAH+BSO – report of three cases

The first case of Ethanol sclerotherapy (EST) in 1998. Management of Recurrent Endometriosis after TAH+BSO, three cases are presented. The objective is to bring to focus the pitiable plight of these women suffering from severe pain abdomen prior to surgery and again after surgery due to recurrent disease. The dilemma of the doctor in deciding the best possible method of managing these cases. To present the different methods adopted to alleviate the pain and treat recurrences three decades ago. To discuss the current management trends. Case Report 1: Mrs. L. 46 years P2 L2 was operated for stage IV endometriosis. TAH+BSO was done on 5.2.96. A scan was done on 27.7.97 revealed an endometriotic cyst in the pelvis, 4.9x4.8 cms and 40 ml of thick chocolate material was aspirated vaginally. Ethanol, 5 ml was injected in the cyst. By three months there was reformation of endometrioma and a repeat second aspiration was done. Danazol 400 mgs/day, in divided doses was given for three months. Two years after TAH+BSO, third time aspiration of 7 ml thick chocolate liquid was done from 2 cms cyst and 4 ml spirit, absolute alcohol was injected on 15.1.98. We present our first case of ethanol sclerotherapy to treat recurrent endometriotic cyst after hysterectomy and bilateral salpingo oophorectomy in 1996-1998. In two other cases ERT had resulted in early recurrence of endometriosis, hence should be avoided. Endometriosis being a recurrent disease, the management decisions had to be individualized. We have discussed about Ethanol sclero therapy, reasons for recurrence after TAH+BSO, and the side effects of Danazol.