Clinical Observation of Endometriotic Patients Treated with Mifepristone after Conservative Surgery

Objective To evaluate the efficacy and side effects of mifepristone on endometriotic patients after conservative surgery and the effects of endocrine response.Methods One hundred and sixty-eight women with moderate or severe endometriosis after conservative surgery were divided into three groups:mifepristone group(91 cases,mifepristone 10 mg/d,6 months);gonadotropin releasing hormone agonist(GnRH-a) group(46 cases,hypodermically leuprorelin acetate 3.75 mg,once per twenty-eight days for 6 months);control group(31 cases) did not receive any postoperative medical treatment.Patients,symptoms and signs including pelvic pain,and pelvic tenderness were recorded before and after treatment.Side-effects were recorded after treatment.Sex hormone levels were also examined at the same time.Results Pelvic pain and uterine cramping of all patients were relieved;both mifepristone group and GnRH-a treatment group achieved significant relief of pelvic symptoms and signs(89.0% and 89.3%) than that(54.8%) of the control group(P0.05).The cumulative recurrence rates of mifepristone group and GnRH-a group were 6.59% and 6.38% respectively,significantly lower than those(19.3%) of control group(P0.05).there were no significant differences between mifepristone group and GnRH-a group(P0.05).Serum estradiol(E2) level was significantly reduced in both mifepristone and GnRH-a groups,but was maintained at the level of early follicular phase in the group of mifepristone(119.4±16.9)pmol·L-1 and menopause phase level in the group of GnRH-a(58.2±11.6)pmol·L-1.Conclusion Treatment of endometriosis with mifepristone appears to be effective in improving the symptoms and signs without significant effect on blood sex hormone and bone density.