Pre or post-operative medical treatment with nafarelin in stage III–IV endometriosis: a French multicenter study

A Audebert, Audebert A, Philippe Descamps, Descamps P, P. Descamps, H. Marret, Marret H, Ory-Lavollee L, L Ory-Lavollee, L. Ory‐Lavollée, François Bailleul, F Bailleul, Bailleul F, S. Hamamah, Hamamah S
European journal of obstetrics, gynecology, and reproductive biology · 1998 · vol. 79(2) , pp. 145–148 · doi:10.1016/s0301-2115(98)00028-1 · PMID:9720832 · W2058175658
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This multicenter study investigated the efficacy of nafarelin treatment administered either before or after surgery for stage III-IV endometriosis.

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Abstract

ObjectivesTo determine the effectiveness of a 6-month course of nafarelin in the treatment of stage III-IV endometriosis and to determine if pre-operative use of nafarelin facilitates surgery.DesignProspective, multicenter, clinical trial.SettingEight university hospitals and two private practice institutions in France.PatientsFifty-five patients with stage III and IV endometriosis. Two were excluded.InterventionsThe severity of endometriosis was assessed at the time of laparoscopy and patients were randomized to have either laparosopic surgery at that time following 6 months of nafarelin therapy (n=28), or laparoscopic surgery following 6 months of nafarelin therapy (n=25). All had 200 microg intranasal nafarelin twice a day for 6 months and a second look laparoscopy.Main outcome measureClinical efficacy, tolerance to the treatment.ResultsEfficacy and tolerance to the treatment were the same in both groups. AFS scores compared on both laparoscopies were significantly better if nafarelin was given prior to surgery (P=0.007).ConclusionsThis preliminary study shows that in cases of combined medico-surgical treatment for stage III-IV endometriosis, preoperative medical treatment with GnRH-a gives a better AFS score improvement, but no conclusion was possible whether preoperative treatment facilitates surgery.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Hormones Nafarelin Adult Double-Blind Method Endometriosis Female Hormones Humans Laparoscopy Nafarelin Nafarelin Prospective Studies

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