Postoperative administration of monophasic combined oral contraceptives after laparoscopic treatment of ovarian endometriomas: A prospective, randomized trial

L Muzii, Ludovico Muzii, R Marana, Marana R, Riccardo Marana, Caruana P, Paul Caruana, P Caruana, G F Catalano, Catalano GF, Giovan Fiore Catalano, Margutti F, Ferdinando Margutti, F Margutti, P B Panici, Pierluigi Benedetti Panici, Panici PB
American journal of obstetrics and gynecology · 2000 · vol. 183(3) , pp. 588–592 · doi:10.1067/mob.2000.106817 · PMID:10992178 · W2088480185
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This study investigated whether postoperative administration of combined oral contraceptives could prevent endometrioma recurrence after laparoscopic surgery.

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Abstract

ObjectiveWe sought to evaluate the efficacy of postoperative administration of monophasic, combined, low-dose oral contraceptives on endometrioma recurrence and on persistence-recurrence of associated pain symptoms after laparoscopic treatment of moderate-to-severe endometriosis.Study designIn a prospective, randomized trial 70 patients who were not attempting to conceive, aged 20 to 35 years, underwent laparoscopic excision of ovarian endometriomas, followed by either postoperative administration of low-dose cyclic oral contraceptives for 6 months or no treatment on the basis of a computer-generated sequence. At 3 and 6 months after surgery and then at 6-month intervals, both groups underwent ultrasonographic examination for possible evidence of endometrioma recurrence and for evaluation of the absence, persistence, or recurrence of pain symptoms.ResultsTwo patients in the oral contraceptive group did not complete the study. After a mean follow-up of 22 months (range, 12-48 months), there were 2 (6.1%) endometrioma recurrences in the 33 patients who received postoperative oral contraceptives versus 1 (2.9%) recurrence in the 35 patients in the control group (not significant). The moderate-to-severe pain recurrence rate was 9.1% in the oral contraceptive group versus 17.1% in the control group (not significant). The mean time to recurrence of either symptoms or endometriomas was 18.2 months in the oral contraceptive group versus 12.7 months in the control group. The 12-month cumulative recurrence rate at life-table analysis was significantly lower for patients receiving oral contraceptives versus control subjects, whereas no significant difference was evident at 24 and 36 months.ConclusionPostoperative administration of low-dose cyclic oral contraceptives does not significantly affect the long-term recurrence rate of endometriosis after surgical treatment. A delay in recurrence is evident at life-table analysis.

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Condition tags

endometriosis

MeSH descriptors

Contraceptives, Oral, Combined Endometriosis Laparoscopy Ovarian Diseases Adult Contraceptives, Oral, Combined Contraceptives, Oral, Combined Endometriosis Endometriosis Female Humans Ovarian Diseases Ovarian Diseases Pain Postoperative Period Prospective Studies Recurrence Time Factors Ultrasonography

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