The Efficacy of GnRH Analogue on Pain Treatment after Laparoscopic Cystectomy of Endometrioma

Objective : To estimate the efficacy of GnRH analogue on pain treatment after laparoscopic cystectomy of endometrioma. Methods : During a 12-month period from March 2000 to February 2001 in Chonnam National University Hospital, Sixty five patients with ovarian cysts were diagnosed as endometrioma by clinical examination, ultrasonogram and serum CA 125 level. The laparoscopic cystectomy was performed and 65 consecutive women were biopsy-proved endometrioma. They were treated with GnRH analogue intramuscular injection every 4 weeks over a period of 6 months after operation. 10-point linear visual analogue scales for pelvic pain were completed pre- and posttreatment at 6 months and 12 months. Results : A total of 96 endometriotic cysts (21 cysts were bilateral) were found in the 65 patients. 65 patients had a pain associated with endometriosis. 40 patients of them complained of a dysmenorrhea, 14 patients for dyspareunia, and 24 patients for non-menstrual pain. At preoperative, the mean pain score was 5.852.28 (meanSD) for dysmenorrhea; for dyspareunia, 5.291.49; for non-menstrual pain, 5.332.10. At 6 months and 12 months, the mean pain score was 3.201.68 and 2.421.9 for dysmenorrhea; for dyspareunia, 3.711.73 and 3.571.79; for non-menstrual pain, 3.632.26 and 3.291.97. The mean pain score for pelvic pain decreased after combined treatment. Conclusion : The laparoscopic cystectomy of ovarian endometrioma is an effective treatment for pelvic pain and the combination therapy with GnRH analogue is more useful to relieving pelvic pain after operation.