Dienogest vs GnRH agonists as postoperative therapy after laparoscopic eradication of deep infiltrating endometriosis with bowel and parametrial surgery: a randomized controlled trial

Marcello Ceccaroni, Roberto Clarizia, Stefano Liverani, Agnese Donati, Matteo Ceccarello, M Manzone, Maria Manzone, Giovanni Roviglione, Simone Ferrero
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2021 · vol. 37(10) , pp. 930–933 · doi:10.1080/09513590.2021.1929151 · PMID:34036845 · W3165245724
article OA: closed CC0 ⤵ 41 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This trial found dienogest to be non-inferior to GnRH agonists in reducing pain recurrence after deep infiltrating endometriosis surgery, with better patient tolerability and similar relapse and pregnancy rates.

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Abstract

Background The recurrence of deep infiltrating endometriosis (DIE) after its surgical excision is a big problem: postoperative treatment is crucial.Objective To compare two postoperative treatments: Dienogest and GnRH agonists.Design Prospective Randomized Controlled Trial (RCT).Patients 146 women submitted to laparoscopic eradication of DIE with bowel and parametrial surgery.Interventions Patients were randomized into two groups. Group A (n = 81) received Triptorelin or Leuprorelin 3.75 mg every 4 weeks for 6 months. Group B (n = 65) received Dienogest 2 mg/day for at least 6 months. A first interview made after six months valued compliance to therapy, treatment tolerability, pain improvement, and side effects. A second interview at 30 ± 6 months valued pain relapse, imaging relapse, and pregnancy rate.Main outcomes The primary outcome was to demonstrate the non-inferiority of Dienogest about the reduction in pain recurrence. Secondary outcomes were differences in terms of treatment tolerability, side effects, imaging relapse rate, and pregnancy rate.Results Both Dienogest and GnRH agonists were associated with a highly significant reduction of pain at 6 and 30 months, without any significant difference (p < .001). About treatment tolerability, a more satisfactory profile was reported with Dienogest (p = .026). No difference in terms of clinical relapse, imaging relapse, and live births was found.Conclusions Dienogest has proven to be as effective as GnRH agonists in preventing recurrence of DIE and associated pelvic pain after surgery. Also, it is better tolerated by patients.

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Condition tags

endometriosischronic_pelvic_paindie_deep_infiltrating

MeSH descriptors

Endometriosis Gonadotropin-Releasing Hormone Laparoscopy Nandrolone Postoperative Care Endometriosis Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Humans Intestines Intestines Laparoscopy Leuprolide Leuprolide Nandrolone Nandrolone Pelvic Pain Pelvic Pain

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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