Effect of preoperative drug therapy before laparoscopic ovarian endometrioma

Takehiko Tsuchiya, Toshimitsu Maemura, Mamoru Kitamura, Takashi Shibutani, Eijiro Hayata, Yusuke Fukuda, Tomoko Taniguchi, Yukiko Katagiri, Mineto Morita
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2017 · vol. 33(2) , pp. 176–182 · doi:10.5180/jsgoe.33.2_176 · W2791833793
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

Preoperative dienogest treatment for ovarian endometrioma shortened operative and coagulation times and reduced the number of primary follicles in resected specimens compared to GnRH analog or no treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This randomized study evaluated hormonal preoperative therapy in 30 women scheduled for laparoscopic ovarian endometrioma surgery between 2010 and 2013, comparing a GnRH analog (G group), dienogest (D group), and no pre-treatment control (non-T). Outcomes included operative time, total bleeding, cyst wall peeling time, coagulation time, and the number of primary follicles assessed pathologically in the resected specimen. The authors found no group differences in endometrioma size, revised ASRM score, or bleeding volume, but operative time and coagulation time were shorter in the dienogest group than in the GnRH analog and no-treatment groups. A key limitation noted by design is the relatively small sample size, and the main fertility-related caveat is the observed reduction in primary follicles with dienogest. This paper is centrally about endometriosis — it tests preoperative drug therapy (dienogest vs GnRH analog) before laparoscopic removal of ovarian endometriomas.

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Abstract

The preservation of ovarian function during tumor removal is an important problem because ovarian endometrioma is most common in young women of reproductive age. The aim of this study was to evaluate the effect and value of hormonal treatment before laparoscopic surgery. Thirty patients scheduled to undergo laparoscopy for ovarian endometrioma from 2010 to 2013 were randomly assigned to three groups: the GnRH analog for preoperative treatment group (G group), dienogest for preoperative treatment group (D group), and no treatment group (non-T group). Operative time, total amount of bleeding, cystic wall peeling time, coagulation time, and number of primary follicles (assessed pathologically) were compared among the groups. There were no differences in the size of the endometrioma, revised American Society for Reproductive Medicine score, or amount of bleeding among the three groups. Operative time was shorter in the D group (44.6 min) compared to that in the G group (61.2 min) and non-T group (52.2 min). Coagulation time was shorted in the D group (34.3 s) than that in the G group (62.5 s) and non-T group (89.3 s). The number of follicles in the resected specimen was lower in the D group (0.8 follicles per microscopic field) than that in the G group (1.7 follicles per microscopic field) and non-T group (4.0 follicles per microscopic field). The use of dienogest for preoperative treatment facilitates minimally invasive surgery for ovarian endometrioma by shortening the coagulation time and reducing the number of primary follicles in the resected specimen.
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原著論文 腹腔鏡下卵巣チョコレート嚢胞摘出術における術前薬物療法の検討 2017 年 33 巻 2 号 p. 176-182 詳細 抄録 The preservation of ovarian function during tumor removal is an important problem because ovarian endometrioma is most common in young women of reproductive age. The aim of this study was to evaluate the effect and value of hormonal treatment before laparoscopic surgery. Thirty patients scheduled to undergo laparoscopy for ovarian endometrioma from 2010 to 2013 were randomly assigned to three groups: the GnRH analog for preoperative treatment group (G group), dienogest for preoperative treatment group (D group), and no treatment group (non-T group). Operative time, total amount of bleeding, cystic wall peeling time, coagulation time, and number of primary follicles (assessed pathologically) were compared among the groups. There were no differences in the size of the endometrioma, revised American Society for Reproductive Medicine score, or amount of bleeding among the three groups. Operative time was shorter in the D group (44.6 min) compared to that in the G group (61.2 min) and non-T group (52.2 min). Coagulation time was shorted in the D group (34.3 s) than that in the G group (62.5 s) and non-T group (89.3 s). The number of follicles in the resected specimen was lower in the D group (0.8 follicles per microscopic field) than that in the G group (1.7 follicles per microscopic field) and non-T group (4.0 follicles per microscopic field). The use of dienogest for preoperative treatment facilitates minimally invasive surgery for ovarian endometrioma by shortening the coagulation time and reducing the number of primary follicles in the resected specimen. © 2017 日本産科婦人科内視鏡学会

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endometrioma

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