Postoperative Hormonal Suppression for Prevention of Deeply Infiltrative Endometriosis Recurrence After Surgery

Purpose of Review The long-term management of deeply infiltrative endometriosis (DIE) remains debatable. Surgical excision improves pain and fertility in patients with endometriosis, however recurrence is common. In this article, we present an evidence-based approach of recurrence and postoperative hormonal suppression in DIE. Recent Findings A clear understanding of recurrence patterns and methods for prevention of DIE are lacking. Repeat surgery in DIE patients is associated with increased morbidity. Older data has suggested the limited utility of short-term postoperative hormonal suppression for the prevention of pain or disease recurrence for patients with endometriosis (Yap et al., Cochrane Database Syst Rev. (3):CD003678, 2004). More recent studies suggest that long-term medical therapy with oral contraceptive pills (OCPs) or progesterone only pills (POPs) reduces recurrence of superficial disease and endometriomas. Limited data, however, exists for DIE. Summary This article reviews the literature of hormonal suppression for the prevention of postoperative recurrence of DIE. Despite the dearth of data, the current evidence suggests the utility of long-term postoperative hormonal suppression after surgery especially in those who underwent incomplete excision of DIE. Longer follow-up studies are greatly needed. Similar content being viewed by others

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Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of Interest Jessica Opoku-Anane, Paul Tyan, Jordan S. Klebanoff, and Jensara Clay declare no conflict of interest. Dr. Moawad is a speaker for Intuitive Surgical. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors. Additional information This article is part of the Topical Collection on Minimally Invasive Gynecologic Surgery Rights and permissions About this article Cite this article Opoku-Anane, J., Tyan, P., Klebanoff, J.S. et al. Postoperative Hormonal Suppression for Prevention of Deeply Infiltrative Endometriosis Recurrence After Surgery. Curr Obstet Gynecol Rep 7, 133–138 (2018). https://doi.org/10.1007/s13669-018-0246-2 Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s13669-018-0246-2