Effectiveness of medical therapy for preventing ovarian endometriosis recurrence after surgical treatment

М.Р. Оразов, Viktor E. Radzinsky, R.E. Orekhov, M.B. Tairova
In: Voprosy ginekologii, akušerstva i perinatologii · 2022 · vol. 21(3) , pp. 53–62 · doi:10.20953/1726-1678-2022-3-53-62 · W4313318912
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Postoperative dienogest therapy for 24 weeks significantly reduced ovarian endometriosis recurrence and associated pain compared to no hormonal therapy over 12 months.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This prospective observational comparative study evaluated whether postoperative dienogest (2 mg daily for 24 weeks) prevents ovarian endometriosis recurrence after surgery in 104 women aged 20–49 with morphologically verified ovarian endometriosis, compared with no postoperative hormonal therapy, with 12 months of follow-up. Recurrence within 12 months was 1/82 (1.22%) in the dienogest group versus 5/22 (22.7%) without hormonal therapy, and pain intensity decreased significantly after 3 months (from moderate to mild) and further improved by 6 months (to mild or complete relief) on NRS/VAS scales. In the no-therapy group, pain intensity increased and inflammatory marker levels (IL-17, IL-6, IL-10, TNF-α) did not change significantly, whereas the dienogest group showed significant decreases in all examined inflammatory markers and CA-125. The paper does not clearly state randomization and includes a smaller untreated group, which may limit causal inference; this paper is centrally about endometriosis — preventing ovarian endometriosis recurrence after surgery using dienogest.

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Abstract

Objective. To study the effectiveness of therapy with dienogest (Zafrilla) in the prevention of ovarian endometriosis recurrence after surgical treatment. Patients and methods. This prospective observational comparative study enrolled 104 patients aged 20 to 49 years with morphologically verified diagnosis of ovarian endometriosis. Patients were divided into groups. Group 1 (n = 82) received postoperative therapy with dienogest (Zafrilla) (2 mg once daily for 24 weeks); group 2 (n = 22) did not receive postoperative hormonal therapy. The duration of postoperative follow-up was 12 months. Results. The recurrence rate of ovarian endometriosis within 12 months was 1.22% (1 out of 82) in group 1 and 22.7% (5 out of 22) in group 2. Against the background of postoperative therapy with dienogest in group 1, there was a statistically significant decrease in the average pain intensity and its transformation from moderate to mild after 3 months of therapy (2.5-fold on average) and to mild or complete relief after 6 months (5-fold on average, compared to the values before therapy), according to pain assessment scales (NRS, VAS). Group 2 showed a statistically significant increase in the average pain intensity on all scales and no statistically significant change in serum concentrations of the examined markers (IL-17, IL-6, IL-10, TNF-α), while group 1 demonstrated a statistically significant decrease in serum concentrations of all the examined inflammatory markers and the CA-125 marker. Conclusion. Dienogest (Zafrilla) can be considered as the main therapeutic approach for the long-term prevention of ovarian endometriosis recurrence after surgical treatment. Key words: endometriosis, ovarian endometriomas, pelvic pain, dienogest, quality of life, inflammatory markers
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Effectiveness of medical therapy for preventing ovarian endometriosis recurrence after surgical treatment Mekan R.Orazov / Victor E. Radzinsky / Roman E. Orekhov / Marina B. Tairova / Objective. To study the effectiveness of therapy with dienogest (Zafrilla) in the prevention of ovarian endometriosis recurrence after surgical treatment. Patients and methods. This prospective observational comparative study enrolled 104 patients aged 20 to 49 years with morphologically verified diagnosis of ovarian endometriosis. Patients were divided into groups. Group 1 (n = 82) received postoperative therapy with dienogest (Zafrilla) (2 mg once daily for 24 weeks); group 2 (n = 22) did not receive postoperative hormonal therapy. The duration of postoperative follow-up was 12 months. Results. The recurrence rate of ovarian endometriosis within 12 months was 1.22% (1 out of 82) in group 1 and 22.7% (5 out of 22) in group 2. Against the background of postoperative therapy with dienogest in group 1, there was a statistically significant decrease in the average pain intensity and its transformation from moderate to mild after 3 months of therapy (2.5-fold on average) and to mild or complete relief after 6 months (5-fold on average, compared to the values before therapy), according to pain assessment scales (NRS, VAS). Group 2 showed a statistically significant increase in the average pain intensity on all scales and no statistically significant change in serum concentrations of the examined markers (IL-17, IL-6, IL-10, TNF-α), while group 1 demonstrated a statistically significant decrease in serum concentrations of all the examined inflammatory markers and the CA-125 marker. Conclusion. Dienogest (Zafrilla) can be considered as the main therapeutic approach for the long-term prevention of ovarian endometriosis recurrence after surgical treatment. Key words: endometriosis, ovarian endometriomas, pelvic pain, dienogest, quality of life, inflammatory markers For citation: Orazov M.R., Radzinsky V.E., Orekhov R.E., Tairova M.B. Effectiveness of medical therapy for preventing ovarian endometriosis recurrence after surgical treatment. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2022; 21(3): 53–62. (In Russian). DOI: 10.20953/1726-1678-2022-3-53-62

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endometriosis

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