Is dienogest a convenient treatment option for cesarean scar endometriosis or should it be treated surgically?

Kerem Doga Seckin, Kerem Doğa Seçkin, Seckin KD, Kadirogullari P, Pinar Kadirogullari, Pınar Kadiroğullari
European journal of obstetrics, gynecology, and reproductive biology · 2023 · vol. 282 , pp. 110–115 · doi:10.1016/j.ejogrb.2023.01.025 · PMID:36706661 · W4317754350
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This paper discusses the convenience of dienogest as a treatment for cesarean scar endometriosis compared to surgical intervention.

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Abstract

OBJECTIVES: Endometriosis-related conditions such as subcutaneous endometriosis have been frequently seen in recent years, and dienogest or surgical excision is generally preferred as a treatment option. Our aim in this study is to determine which treatment option will be more effective in reducing the symptoms of patients with cesarean scar endometriosis. Study design This prospective study was performed with 21 patients diagnosed with cesarean scar endometriosis. The demographic features of the patients, lesion sizes before and after medical and surgical treatment, VAS scores and Ca-125 levels were recorded. VAS scores and lesion sizes were compared before-after medical treatment and before-after surgery in same group. RESULTS: A total of 18 women were identified, with a mean age of 32.3 ± 5.7 years. No significant decrease in lesion size was observed in the 1st and 6th-month controls after the use of dienogest (p > 0,05), while a significant decrease in VAS scores was detected (p < 0,05). After surgery, the decrease in both lesion size and VAS scores was found statistically significant (p < 0,05). CONCLUSION: Dienogest, which is frequently used in the medical treatment of pelvic and ovarian endometriosis, reduces pain minimally in cesarean scar endometriosis but does not provide a change in lesion size. Therefore, surgical treatment of cesarean scar endometriosis seems to be more effective in reducing pain and decreasing the size of the lesions.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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References (47)

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europepmc
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License: CC0 · commercial use OK