Long-term hormonal treatment reduces repetitive surgery for endometriosis recurrence

Capezzuoli T, Tommaso Capezzuoli, Silvia Vannuccini, Daniele Mautone, Mautone D, Sorbi F, Flavia Sorbi, Huixi Chen, Reis FM, Fernando M. Reis, Marcello Ceccaroni, Petraglia F, Felice Petraglia
Reproductive BioMedicine Online · 2020 · vol. 42(2) , pp. 451–456 · doi:10.1016/j.rbmo.2020.09.018 · PMID:33277193 · W3088875065
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This paper reports that long-term hormonal treatment effectively reduced the need for repeat surgeries in patients experiencing endometriosis recurrence.

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Abstract

Research questionHow effective is medical hormonal treatment in preventing endometriosis recurrence and in improving women's clinical symptoms and quality of life?DesignThis observational cross-sectional study evaluated the effects of hormonal medical treatment (progestins, gonadotrophin-releasing hormone analogues or continuous oral contraceptives) on endometriosis recurrence, current clinical symptoms and quality of life in three groups of patients: Group A (n = 34), no hormonal treatment either before or after the first endometriosis surgery; Group B (n = 76), on hormonal treatment after the first endometriosis surgery; and Group C (n = 75), on hormonal treatment both before and after the first endometriosis surgery.ResultsGroup C patients were characterized by a lower rate of endometriosis reoperation (P = 0.011) and a lower rate of dysmenorrhoea (P = 0.006). Women who experienced repetitive endometriosis surgery showed worse physical (P = 0.004) and mental (P = 0.012) status than those who received a single surgery, independent of the treatment.ConclusionHormonal treatments represent a valid cornerstone of endometriosis management and may be useful as an alternative to surgery, but also before surgery, to plan better, and after surgery in order to reduce the risk of recurrence. Medical counselling is very helpful in choosing the correct and individualized endometriosis treatment. In fact, the gold standard for modern endometriosis management is the individualized approach and surgery should be considered, depending on the clinical situation and a patient's symptoms.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gynecologic Surgical Procedures Hormones Reoperation Secondary Prevention Adult Cross-Sectional Studies Endometriosis Endometriosis Female Gynecologic Surgical Procedures Hormones Humans Reoperation Secondary Prevention Young Adult

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