Effectiveness of Conservative Surgery and Adjunctive Hormone Suppression Therapy versus Surgery Alone in the Treatment of Symptomatic Endometriosis: A Systematic Review with Meta-analysis

Nargis Momotaz Lata, Khondaker Bulbul Sarwar
In: Bangladesh Journal of Medical Science · 2013 · vol. 13(1) , pp. 8–13 · doi:10.3329/bjms.v13i1.17377 · W2084884679
review OA: diamond CC0 ⤵ 1 in-corpus citation
🔓 Open OA copy Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This meta-analysis found no significant benefit for hormone suppression therapy following conservative surgery compared to surgery alone for symptomatic endometriosis recurrence or pelvic pain recurrence.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This systematic review and meta-analysis included randomized controlled trials comparing conservative surgery plus adjunctive hormone suppression therapy versus surgery alone (or surgery plus placebo) for symptomatic endometriosis, assessing outcomes such as pelvic pain and disease recurrence. Across 8 trials where pelvic pain was reported in 7, no significant benefit of post-surgical hormone therapy was found for pelvic pain recurrence (RR=0.75, 95% CI 0.54 to 1.04) or disease recurrence (RR=0.89, 95% CI 0.53 to 1.49). While two additional trials showed significant improvement in pelvic pain score (SMD −0.86, 95% CI −1.11 to −0.61), there was substantial heterogeneity (I²=95%). The paper concludes there were no advantages for endometriosis and pelvic pain recurrence with post-surgical hormone therapy compared with surgery alone. This paper is centrally about endometriosis — it specifically evaluates whether adjunctive hormone suppression after conservative surgery improves pelvic pain and recurrence versus surgery alone in symptomatic endometriosis.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Background: Endometriosis is one of the common gynaecological problems mostly affecting the women in reproductive age, associated with non menstrual pelvic pain and other symptoms and recurrence of endometriosis is common after medical or even surgical treatment. Objectives: This review is done to assess, whether conservative surgery and adjunctive hormone suppression therapy is more beneficiary than surgery alone in the treatment of symptomatic endometriosis in term of pelvic pain and disease recurrence. Data sources and search method: Searched had been performed on Cochrane Central Register of Controlled trials, MEDLINE, PsycINFO. Journals and reference lists had been also searched. Review methods: Only Randomized controlled trials were included if they compared the effectiveness of hormone therapy following conservative surgery with surgery alone or surgery plus placebo in the treatment of symptomatic endometriosis. Outcome data had been analysed by using a Mantel-Haenzel Fixed-effect model to perform meta-analysis and results had been presented as Risk ratio for binary data and Standardised Mean difference for continuous data with 95% confidence intervals. Results: Out of 8 trails pelvic pain was reported in 7 trials. No significant benefit was observed both in pelvic pain recurrence (RR= 0.75, 95% Cl- 0.54 to1.04) and disease recurrence (RR 0.89, 95% Cl 0.53 to 1.49) among 5 trials (481& 447 participants) in favour of surgery and adjunctive hormone therapy. On the other hand another 2 trials (280 participants) showed significant benefit in pelvic pain score (Std. Mean difference-0.86, 95%Cl -1.11 to -0.61) but considerable heterogeneity (I²= 95%) was observed. Conclusion: Women who received Post-surgical hormone therapy in the treatment of symptomatic endometriosis had no advantages in respect of endometriosis and pelvic pain recurrence in compared with surgery alone. DOI: http://dx.doi.org/10.3329/bjms.v13i1.17377 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 8-13
Full text 3,449 characters · extracted from oa-doi-fallback · 3 sections · click to expand

Background

Endometriosis is one of the common gynaecological problems mostly affecting the women in reproductive age, associated with non menstrual pelvic pain and other symptoms and recurrence of endometriosis is common after medical or even surgical treatment.

Objectives

This review is done to assess, whether conservative surgery and adjunctive hormone suppression therapy is more beneficiary than surgery alone in the treatment of symptomatic endometriosis in term of pelvic pain and disease recurrence. Data sources and search method: Searched had been performed on Cochrane Central Register of Controlled trials, MEDLINE, PsycINFO. Journals and reference lists had been also searched. Review methods: Only Randomized controlled trials were included if they compared the effectiveness of hormone therapy following conservative surgery with surgery alone or surgery plus placebo in the treatment of symptomatic endometriosis. Outcome data had been analysed by using a Mantel-Haenzel Fixed-effect model to perform meta-analysis and results had been presented as Risk ratio for binary data and Standardised Mean difference for continuous data with 95% confidence intervals. Results: Out of 8 trails pelvic pain was reported in 7 trials. No significant benefit was observed both in pelvic pain recurrence (RR= 0.75, 95% Cl- 0.54 to1.04) and disease recurrence (RR 0.89, 95% Cl 0.53 to 1.49) among 5 trials (481& 447 participants) in favour of surgery and adjunctive hormone therapy. On the other hand another 2 trials (280 participants) showed significant benefit in pelvic pain score (Std. Mean difference-0.86, 95%Cl -1.11 to -0.61) but considerable heterogeneity (I²= 95%) was observed.

Conclusion

Women who received Post-surgical hormone therapy in the treatment of symptomatic endometriosis had no advantages in respect of endometriosis and pelvic pain recurrence in compared with surgery alone. DOI: http://dx.doi.org/10.3329/bjms.v13i1.17377 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 8-13 Downloads 378 300 Downloads Published How to Cite Issue Section License Authors who publish in the Bangladesh Journal of Medical Science agree to the following terms that: - Authors retain copyright and grant Bangladesh Journal of Medical Science the right of first publication of the work. Articles in Bangladesh Journal of Medical Science are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.- Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. - Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (27)

Cited by (1)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK