Efficacy of pharmacotherapy in patients with deep endometriosis and chronic pelvic pain syndrome
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Objective. To study the efficacy of dienogest in the conservative management of patients with deep endometriosis (DE) and chronic pelvic pain syndrome (CPPS). Patients and methods. The study included 25 reproductive-aged patients (Me = 33.5 years) with DE and CPPS who had not undergone surgical treatment for endometriosis. Complaints, quality of life (Medical Outcomes Study-Short form, MOS SF-36), pelvic examination and pelvic ultrasound before and after therapy with dienogest 2 mg (Zafrilla) considering ENZIAN (U) classification were evaluated. Treatment efficacy was assessed at 3 and 6 months after continuous medication use. Results. Patients with DE and CPPS presented the following common complaints: dysmenorrhea (80% of women) and dyspareunia (72%), and one in two patients (56%) had flatulence during menstruation (p < 0.05). This category of patients showed a significant decrease in the quality of life according to all 8 transformed scales, which amounted to 40–69% (p < 0.05). A 6-month therapy with Zafrilla statistically significantly reduced the intensity of pain by 55.5%, improved the quality of life by more than 2 times, which is due to a 44.4% decrease in the number of complaints of dyspareunia (p < 0.05). Moreover, there was a decrease in the volume of endometriotic lesions and depth of invasion from 12 to 36% according to ultrasound and the new ENZIAN (U) classification, p < 0.05. Conclusion. Conservative therapy for DE with dienogest 2 mg in a continuous regimen improves the quality of life of women by more than 2 times, which is due to a decrease in the intensity and frequency of pain in patients with CPPS (p < 0.05). Key words: dienogest, deep endometriosis, chronic pelvic pain syndrome, ENZIAN (U) classification
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Efficacy of pharmacotherapy in patients with deep endometriosis and chronic pelvic pain syndrome
Tatyana A. Makarenko /
Darya E. Galkina /
Elena A. Borisova /
Inga O. Ulyanova /
Objective. To study the efficacy of dienogest in the conservative management of patients with deep endometriosis (DE) and chronic pelvic pain syndrome (CPPS).
Patients and methods. The study included 25 reproductive-aged patients (Me = 33.5 years) with DE and CPPS who had not undergone surgical treatment for endometriosis. Complaints, quality of life (Medical Outcomes Study-Short form, MOS SF-36), pelvic examination and pelvic ultrasound before and after therapy with dienogest 2 mg (Zafrilla) considering ENZIAN (U) classification were evaluated. Treatment efficacy was assessed at 3 and 6 months after continuous medication use.
Results. Patients with DE and CPPS presented the following common complaints: dysmenorrhea (80% of women) and dyspareunia (72%), and one in two patients (56%) had flatulence during menstruation (p < 0.05). This category of patients showed a significant decrease in the quality of life according to all 8 transformed scales, which amounted to 40–69% (p < 0.05). A 6-month therapy with Zafrilla statistically significantly reduced the intensity of pain by 55.5%, improved the quality of life by more than 2 times, which is due to a 44.4% decrease in the number of complaints of dyspareunia (p < 0.05). Moreover, there was a decrease in the volume of endometriotic lesions and depth of invasion from 12 to 36% according to ultrasound and the new ENZIAN (U) classification, p < 0.05.
Conclusion. Conservative therapy for DE with dienogest 2 mg in a continuous regimen improves the quality of life of women by more than 2 times, which is due to a decrease in the intensity and frequency of pain in patients with CPPS (p < 0.05).
Key words: dienogest, deep endometriosis, chronic pelvic pain syndrome, ENZIAN (U) classification
For citation: Makarenko T.A., Galkina D.E., Borisova E.A., Ulyanova I.O. Efficacy of pharmacotherapy in patients with deep endometriosis and chronic pelvic pain syndrome. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2024; 23(5): 39–46. (In Russian). DOI: 10.20953/1726-1678-2024-5-39-46
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