Post-operative GnRH analogue treatment after conservative surgery for symptomatic endometriosis stage III–IV: a randomized controlled trial

Mauro Busacca, M Busacca, Edgardo Somigliana, E Somigliana, Stefano Bianchi, S Bianchi, S De Marinis, C Calia, M Candiani, Massimo Candiani, M Vignali
Human Reproduction · 2001 · vol. 16(11) , pp. 2399–2402 · doi:10.1093/humrep/16.11.2399 · PMID:11679528 · W2105437500
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This randomized controlled trial found that post-operative GnRH analogue treatment did not significantly reduce pain recurrence or disease recurrence in women with symptomatic endometriosis stage III-IV compared to expectant management.

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Abstract

BACKGROUND: In order to decrease endometriosis recurrence after surgical therapy, it has been proposed to use a post-surgical oestrogen-lowering medical treatment. Results from previous trials on this topic are contradictory. METHODS: A total of 89 women were randomized, by computer-generated list, after laparoscopic conservative surgery for symptomatic endometriosis stage III-IV to receive monthly i.m. injections of gonadotrophin-releasing hormone (GnRH) analogue, leuprolide acetate depot (3.75 mg) for 3 months (n = 44) or to an expectant management (n = 45). All patients were followed up every 6 months for evaluation of pain symptoms, fertility and objective disease recurrence. RESULTS: During the follow-up, which ranged from 6-36 months, five (33%) of the 15 women who wanted children and who were allocated the GnRH analogue and six (40%) of the 15 given no treatment became pregnant (not significant). Moderate/severe pelvic pain recurred during the follow-up in 10 (23%) of the women allocated the GnRH analogue and 11 (24%) of those allocated no treatment; the cumulative pain recurrence rates at 18 months were 23 and 29% respectively (not significant). Four women (9%) treated with GnRH analogue and four women (9%) who received no treatment had objective disease recurrence as demonstrated by gynaecological examination and/or pelvic ultrasonography. CONCLUSIONS: This study does not support the routine post-operative use of a 3 month course of GnRH analogue in women with symptomatic endometriosis stage III-IV.

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Condition tags

mesh:D004412mesh:D004414mesh:D004715mesh:D017699endometriosis

MeSH descriptors

Endometriosis Leuprolide Postoperative Care Adult Delayed-Action Preparations Dysmenorrhea Dysmenorrhea Dyspareunia Dyspareunia Endometriosis Endometriosis Female Humans Leuprolide Leuprolide Pelvic Pain Pregnancy Recurrence Reoperation

Citation neighborhood

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