Postoperative administration of dienogest plus estradiol valerate versus levonorgestrel-releasing intrauterine device for prevention of pain relapse and disease recurrence in endometriosis patients

Michele Morelli, Morelli M, Angela Sacchinelli, Sacchinelli A, Roberta Venturella, Rita Mocciaro, Mocciaro R, Zullo F, Fulvio Zullo
Journal of Obstetrics and Gynaecology Research · 2013 · vol. 39(5) , pp. 985–990 · doi:10.1111/jog.12030 · PMID:23551827 · W1710395003
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Postoperative estradiol valerate plus dienogest significantly reduced pelvic pain and Ca125 levels more than levonorgestrel-releasing IUDs, though recurrence rates were not significantly different, with higher patient satisfaction for the IUD.

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Abstract

AIM: In recent years, both dienogest, a fourth-generation progestin, and levonorgestrel-releasing intrauterine device have been found to be effective in terms of endometriosis-related pelvic pain improvement. No data, however, are available about their efficacy in terms of postoperative recurrence prevention in women recently submitted to surgery for endometriosis at every stage. Our objective was to compare two postoperative medical approaches for pain control and reduction of recurrences in patients undergoing surgery for endometriosis. MATERIAL AND METHODS: Ninety-two patients undergoing surgery for endometriosis and subsequent treatment by estradiol valerate + dienogest (EP) (group A) or levonorgestrel-releasing uterine device (LNG-IUD) (Group B) between January 2009 and June 2010 were retrospectively analyzed. The primary endpoints were pain relapse and disease recurrence rate at 12 and 24 months. The secondary endpoint was patient satisfaction with the therapy at 24 months. RESULTS: Forty-eight patients in Group A and 44 in Group B were examined. At 12 and 24 months a statistically greater reduction both in Ca125 levels and VAS score was seen in women treated with EP compared to LNG-IUD. The recurrence rate at 12 and 24 months follow-up was slightly lower, but not at a significant level, in Group A than in Group B. Finally, satisfaction with treatment at 24 months was significantly higher in Group B. CONCLUSION: EP administration is significantly more effective than LNG-IUD in reducing pelvic pain and more effective in reducing recurrence rate but not at a significant level. LNG-IUD, however, has significantly higher patient satisfaction.

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Outcome instruments

VAS-pain

Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Estradiol Intrauterine Devices, Medicated Intrauterine Devices, Medicated Levonorgestrel Nandrolone Pelvic Pain Adult Adult Combined Modality Therapy Combined Modality Therapy Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Drug Combinations Drug Combinations Endometriosis Endometriosis Endometriosis

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (25)

Cited by (44)

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