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

OBJECTIVE: To investigate the role of adjuvant treatment with gonadotropin-releasing-hormone agonist (GnRHa) following conservative surgical treatment of endometriosis. STUDY DESIGN: Sixty 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). RESULTS: Six 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). CONCLUSION: Triptorelin 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 Adult Chemotherapy, Adjuvant Chemotherapy, Adjuvant Endometriosis Endometriosis Endometriosis Endometriosis Female Female Fertility Fertility Humans Humans Laparoscopy

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