A randomized study comparing triptorelin or expectant management following conservative laparoscopic surgery for symptomatic stage III–IV endometriosis

Giuseppe Loverro, Carmine Carriero, A Cristina Rossi, Rossi AC, Giuseppe Putignano, G Putignano, Putignano G, Vittorio Nicolardi, Selvaggi L, Luigi Selvaggi
European journal of obstetrics, gynecology, and reproductive biology · 2006 · vol. 136(2) , pp. 194–198 · doi:10.1016/j.ejogrb.2006.10.034 · PMID:17178185 · W2134521417
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This randomized study compared triptorelin versus expectant management after conservative laparoscopic surgery for symptomatic stage III–IV endometriosis.

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Abstract

ObjectiveTo investigate the role of adjuvant treatment with gonadotropin-releasing-hormone agonist (GnRHa) following conservative surgical treatment of endometriosis.Study designSixty patients in the reproductive age (mean age 28.6 years), with symptomatic stages III and IV endometriosis following laparoscopic surgery and without previous hormonal treatment were enrolled in a prospective, randomized, controlled trial to compare the effects of 3-month treatment with triptorelin depot-3.75 i.m. (30 patients) versus expectant management using placebo injection (30 patients).ResultsSix patients (one in triptorelin group and five in placebo group) were lost at follow-up, the remaining 54 were suitable for analysis. Pelvic pain persistence or recurrence, endometrioma relapses and pregnancy rate were evaluated during a 5-year follow-up. The results of 29 cases treated with triptorelin and 25 that received placebo did not show significant differences in pain recurrence (P=1, RR=0.94, 95% CI=0.57-1.55), endometrioma relapse (P=0.67, RR=1.29, 95% CI=0.66-2.50), and pregnancy rate in infertile women (P=0.80, RR=0.81, 95% CI=0.37-1.80). Curves of time of pain recurrence and pregnancy during 5-year follow-up did not show significant differences between the two groups (P=0.79 and P=0.51, respectively, using Mantel-Haenzsel logrank test).ConclusionTriptorelin treatment after operative laparoscopy for stage III/IV endometriosis does not appear to be superior to expectant management in terms of prevention of symptoms recurrence and endometrioma relapse, and has no influence on pregnancy rate in endometriosis-associated infertility.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Fertility Luteolytic Agents Pelvic Pain Triptorelin Pamoate Adult Chemotherapy, Adjuvant Endometriosis Endometriosis Endometriosis Female Fertility Humans Laparoscopy Luteolytic Agents Luteolytic Agents Pelvic Pain Pelvic Pain Pregnancy Pregnancy Rate

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