Maintenance dienogest therapy following adjuvant gonadotropin‐releasing hormone agonist treatment after uterus‐sparing surgery in adenomyosis: A retrospective cohort study

I‐San Chan, Teh‐Fu Hsu, Teh-Fu Hsu, Ying‐Chu Shih, Ying-Chu Shih, Yen‐Hou Chang, Yen-Hou Chang, Peng‐Hui Wang, Yi‐Jen Chen
International Journal of Gynecology & Obstetrics · 2022 · vol. 161(3) , pp. 751–759 · doi:10.1002/ijgo.14635 · PMID:36527263 · W4311824214
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Abstract

OBJECTIVE: To investigate the safety and efficacy of adjuvant gonadotropin-releasing hormone agonist (GnRH-a) treatment followed by maintenance dienogest (DNG) therapy after uterus-sparing surgery. METHODS: Retrospective cohort study. A total of 190 patients with severe adenomyosis underwent uterus-sparing surgery between January 2010 and June 2020. Of these patients, 90 were analyzed. Forty-six patients (control group) received adjuvant 6-month GnRH-a therapy alone after uterus-sparing surgery, and 44 patients (maintenance group) received postoperative 6-month GnRH-a treatment followed by maintenance DNG therapy (2 mg/day orally). The median follow-up period was 18 months. The study was analyzed using generalized estimating equations. RESULTS: At baseline, the characteristics of patients in each group were comparable. Compared with the control group, the maintenance group had a significant improvement in the visual analog scale score of dysmenorrhea (P < 0.001), hemoglobin level (P = 0.004), and uterine volume (P = 0.004) from baseline to 18 months after uterus-sparing surgery. The symptom recurrence rate was significantly lower in the maintenance group than in the control group (4.6% vs. 37.0%, P < 0.001). CONCLUSIONS: The findings of this study suggest that combinatorial treatment with GnRH-a (adjuvant treatment) and DNG (maintenance therapy) represents a safe and effective short-term therapy after uterus-sparing surgery for adenomyosis.

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Condition tags

adenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Female Female Female Female Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Humans Humans

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Cited by (6)

SciLite annotations

chemicals 2
dienogest dienogest

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