Do you have endometriosis and are planning a pregnancy? This method may be helpful

We talk about sclerotherapy of endometrial cysts by prof. Rafal Tarkovski, head of gynecological oncology and gynecological clinic of the Independent Public Clinical Hospital No. 1 in Lublin.

What is the innovativeness of the method that you use in the center in Lublin?

Endometriosis is a disease that has many faces. It most often manifests itself as millimeter or multi-millimeter implants in the peritoneum that cause pain. They cause this because they are endometrial cells that follow the same hormonal cycle as the lining of the uterus. So in the first phase of the cycle, they grow, and during menstruation they become necrotic and slough off. But there is another form of endometriosis - endometrial cysts that occur in the ovaries. If they are larger than 4 cm and cause pain, they must be removed. This is usually done surgically by enucleating the cyst. Unfortunately, some healthy, normal ovarian tissue is often lost during this operation. And sclerotherapy is a less invasive and very effective method. This is confirmed by international publications.

What exactly is this treatment?

When puncturing the cyst from the side of the vagina. Then the fluid is removed from the cyst and a 96% solution of ethyl alcohol is injected into it, which causes fibrosis of the focus capsule. The collected material is sent for histopathological examination to rule out cancer. The whole procedure is carried out under ultrasound control, in a one-day mode. The patient is hospitalized in the morning and goes home in the evening. The procedure is performed under short-term intravenous anesthesia with antibiotic prophylaxis.

What are the disadvantages of this method?

We send only liquid for analysis, not whole lesions. In addition, this method is not for everyone, but only for one specific form of endometriosis - to destroy the cyst. It does not cure, for example, endometriosis in the caesarean scar. In addition, not all patients are shown sclerotherapy. To perform it, it is necessary to correctly localize the lesion so that it can be safely punctured without damaging adjacent structures.

Sclerotherapy is especially recommended for young women planning a pregnancy. Why this particular group of women?

Surgery to enucleate an ovarian cyst often carries the risk of destroying healthy tissue, which can result in fertility problems for the patient. And we want to preserve as much normal tissue as possible in young women who are planning a pregnancy. In addition, after this procedure, there is no need for convalescence. Such a patient can proceed to further stages of infertility treatment in a week or two.

What is interesting about your resort?

We opened it a few weeks ago, and more and more people are interested. We do 2-3 operations per day, about 40 per month. But you can still sign up. While the queue does not exceed a month. Of course, the National Health Fund compensates for the treatment.

Do patients report from the other side of Poland?

Yes, because they are looking for a chance for themselves, especially when they are in pain. Unfortunately, patients are often disappointed that their type of endometriosis is not suitable for this procedure. Therefore, before a woman comes to us, she should talk to her doctor. I want to emphasize once again that sclerotherapy is not a method that will replace all the others. This is an alternative, sometimes surgery cannot be avoided. There are people who will always choose surgery, and there are people who will do anything not to have surgery. It is important to offer women different methods so that they have plenty to choose from.

Why is this method still not very popular in Poland?

Endometriosis still holds many mysteries. In addition, almost every doctor has his own view on the treatment of endometriosis. And we want to give patients a choice. Moreover, during these few weeks of the center’s work, we see that many women have poorly treated endometriosis. Either they have the wrong drugs, or they have 2-3 failed surgeries. Or that endometriosis is recurring because they haven’t received additional hormonal treatment. Sclerotherapy will undoubtedly bring relief to many patients. Moreover, its effectiveness is comparable to laparoscopic enucleation of lesions. At the same time, we maintain the ovarian reserve, which is very important for young women.