Hospital SJD Sant Boi takes part in clinical trial to improve the treatment of endometriosis
Alcohol sclerotherapy following ultrasound-guided ovarian cyst aspiration is a less aggressive option for treating endometriomas, which affect up to 40% of women with reproductive problems
This 30-minute outpatient procedure, which usually does not require general anaesthesia, reduces complications and improves pain control
It can prevent around 80% of surgeries for ovarian endometriosis and is five times cheaper than laparoscopy
Hospital Sant Joan de Déu Sant Boi is one of the 20 health centres in Spain that has taken part in a multicentre clinical trial, coordinated by Bellvitge University Hospital and the Bellvitge Biomedical Research Institute (IDIBELL), which confirms that alcohol sclerotherapy after ultrasound-guided aspiration of ovarian cysts is a safe, effective and less invasive alternative to laparoscopic surgery in the treatment of endometriomas.
Endometriosis is a complex, chronic disease with a significant impact on patients' quality of life. Conventional medical and surgical treatments can have adverse effects which may be serious. It affects roughly 10% of women of reproductive age and can cause chronic pain, infertility and a significant impact on daily life. Endometriomas, commonly known as chocolate cysts due to their dense, brown appearance, develop in the 20–40% of women who already have endometriosis. Recent studies show that up to 30-40% of women who seek medical advice for reproductive difficulties have an endometrioma or ovarian endometriosis.
The study, published in the scientific journal Archives of Gynecology and Obstetrics, is the first randomised clinical trial in a real-world setting to compare the two techniques. It involved 167 women aged 18 to 40 with endometriomas measuring up to 10 centimetres.
Dr Manuel Carreras and Dr Rodrigo Guevara from Hospital SJD Sant Boi took part in the study. The Hospital played an active role in recruiting and following up patients by gathering clinical data.
An alternative as effective as surgery with better recovery
The results show that sclerotherapy is as safe as surgery: serious complications are very rare (1.1%). After more than two years of follow-up, recurrence is similar between both groups (22.8% in sclerotherapy vs. 25.7% in surgery), while pain control tends to be better in patients treated with alcohol (89% pain relief or disappearance vs. 66% in those who underwent surgery).
Unlike surgery, the technique does not require hospital admission, does not involve the risk of adhesions or ovarian removal in complex cases, and can better preserve ovarian reserve, especially significant in young women or those who wish to have children. The hospital cost is also almost five times lower than for laparoscopic surgery.
“The results of the study are encouraging and point to major advances in the personalised and multidisciplinary approach to this pathology," said Dr Johanna Parra, head of the Gynaecology Department at Hospital SJD Sant Boi
Breakthrough for women with endometriosis
Until now, surgery has been the standard treatment for endometriomas of a certain size, but it carries risks and can compromise future fertility. This new approach might significantly reduce the number of operations for ovarian endometriosis, especially in young women or those living with chronic pain.
"This is an outpatient therapeutic procedure that makes it easier to manage the disease, has less impact on the patient and improves their quality of life, and in some cases can also avoid the need for complex surgical procedures," commented Dr Johanna Parra. “Taking part in research that drives new diagnostic and therapeutic strategies for this disease is a priority for our department.”
The results confirm the need for personalised treatments based on age, pain, wish to have children and the impact of endometriosis on each woman's daily life.
Hospital SJD Sant Boi keeps up its steadfast commitment to its community through studies such as this one. “We provide our patients with access to leading therapeutic options, build efficient care pathways and collaborate on research projects with Bellvitge University Hospital and other groundbreaking centres which add to scientific knowledge and improve clinical outcomes," argued Dr Parra.
Reference article
García-Tejedor A., et al. Ultrasound-guided ethanol sclerotherapy versus laparoscopic surgery for endometriomas: a randomized clinical trial in a real-world setting. Archives of Gynecology and Obstetrics. 2025. DOI: 10.1007/s00404-025-08205-1
Hospitals taking part in the clinical trial
Twenty hospitals across Spain were involved in the study:
• Hospital Universitari de Bellvitge (coordinating centre)
• Hospital Sant Joan de Déu Sant Boi
• Hospital de Viladecans
• Hospital Universitari MútuaTerrassa
• Hospital Universitari Arnau de Vilanova (Lleida)
• Hospital General de Granollers
• Hospital Santa Caterina (Salt)
• Hospital Universitario Central de Asturias
• Hospital Universitari Son Espases (Majorca)
• Hospital Parc Taulí (Sabadell)
• Hospital Universitario 12 de Octubre (Madrid)
• Hospital General Universitario Santa Lucía (Murcia)
• Hospital General Universitario Los Arcos del Mar Menor (Murcia)
• Hospital Clínico Universitario Lozano Blesa (Zaragoza)
• Hospital San Pedro (Logroño)
• Hospital General de València
• Hospital de la Santa Creu de Tortosa Verge de la Cinta
• Hospital Universitari Joan XXIII (Tarragona)
• Hospital Universitari de Girona Dr. Josep Trueta
• Hospital del Mar (Barcelona)
