DESOGESTREL IN THE PREOPERATIVE TREATMENT OF ENDOMETRIOTIC CYSTS

Daniela-Roxana Albu Matasariu, Maria Iacob, Irina Dumitraşcu, Mihai Onofriescu, Carmen Vulpoi
In: The Medical-Surgical Journal · 2015 · vol. 119(3) , pp. 710–714 · W2575615300
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Preoperative desogestrel treatment for six months reduced endometriotic cyst size and vascularization, leading to decreased intraoperative bleeding and improved surgical dissection.

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Abstract

Endometriosis is an estrogen dependent disease characterized by the presence of endometrial tissue outside the uterus. It affects women of reproductive age and is associated with infertility and pelvic pain, with impact on their mental, physical and social well-being. Aim: To evaluate the effects of continuous desogestrel treatment on cyst size and the risk of intraoperatively bleeding. Material and methods: Our study included two hundred fifty-five patients with infertility and endometriotic cysts operated at the Iasi “Cuza Voda” University Hospital in the interval 2006-2014. One hundred fifty-five patients received 6-month preoperative treatment with 75 micrograms of desogestrel daily. The patients were monitored every three months by vaginal ultrasound associated with Doppler for assessing the cysts size,homogeneity, shape, vascularization, position relative to the uterus and the contralateral ovary, presence of sludge and horizontal levels. Results:There was asignificant decrease in cyst diameter and vascularization in most cases with sludge and low echogenicity. Intraoperatively we noticed less bleeding during cyst dissection and a better cleavage plan between the cyst capsule and the normal ovarian tissue. Conclusions: Treatment with desogestrel for at least 6 months preoperatively has a shrinking effect on the endometriotic cyst, reduces intraoperative bleeding and improves the dissection and operative conditions.

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endometriosisinfertility

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