The Efficacy of Postoperative Cyclic Oral Contraceptives after Gonadotropin-Releasing Hormone Agonist Therapy to Prevent Endometrioma Recurrence in Adolescents

Jong-Wook Seo, Seo JW, Dong-Yun Lee, Dong‐Yun Lee, Lee DY, Byung-Koo Yoon, Yoon BK, Choi D, DooSeok Choi
Journal of Pediatric and Adolescent Gynecology · 2016 · vol. 30(2) , pp. 223–227 · doi:10.1016/j.jpag.2016.10.004 · PMID:27744096 · W2531090919
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This study investigated whether postoperative cyclic oral contraceptives effectively prevent endometrioma recurrence in adolescents previously treated with gonadotropin-releasing hormone agonists.

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Abstract

Study objectiveYoung age is a possible risk factor of endometriosis recurrence after surgery. However, the efficacy of postoperative medical treatment has not been well addressed in adolescents. The purpose of this study was to evaluate whether postoperative medical treatment is as effective in adolescents as it is in adults in the prevention of endometrioma recurrence.DesignA retrospective cohort study.SettingSamsung Medical Center, Seoul, Korea.ParticipantsThis study included 176 reproductive-aged women who underwent conservative laparoscopic surgery for pathology-confirmed endometrioma. Women were classified into 2 groups according to age: adolescents (20 years of age and younger, n = 34; group I) and reproductive-aged women (aged 25-35 years, n = 142; group II).InterventionsThe same surgeon performed all of the surgeries for uniformity. Postoperatively, patients were treated monthly with a gonadotropin-releasing hormone agonist depot for 3-6 months, followed by cyclic oral contraceptives.Main outcome measuresEndometrioma recurrence was determined using ultrasonography. The recurrence rate of endometrioma was compared between the 2 groups.ResultsDuring the treatment period (median, 41.0 months; range, 6-159 months), recurrence was noted in 8 cases (4.5%). After adjusting for confounders (which were statistically different between the groups), the cumulative proportion of recurrent endometriomas after 60 months was comparable between the 2 groups (5.3% in group I and 8.5% in group II).ConclusionLong-term postoperative medical treatment with cyclic oral contraceptives after a gonadotropin-releasing hormone agonist can be as effective in adolescents as it is in adults in the prevention of endometrioma recurrence.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Contraceptives, Oral Endometriosis Gonadotropin-Releasing Hormone Postoperative Complications Secondary Prevention Adolescent Adult Combined Modality Therapy Contraceptives, Oral Endometriosis Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Humans Laparoscopy Postoperative Complications Postoperative Complications Recurrence Republic of Korea

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