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Gonadotrophin-releasing hormone analogue or dienogest plus estradiol valerate to prevent pain recurrence after laparoscopic surgery for endometriosis: a multi-center randomized trial.

AbstractOBJECTIVES:
To evaluate the efficacy of dienogest + estradiol valerate (E2V) and gonadotrophin-releasing hormone analogue (GnRH-a) in reducing recurrence of pain in patients with chronic pelvic pain due to laparoscopically diagnosed and treated endometriosis.
DESIGN:
Multi-center, prospective, randomized study.
SETTING:
Three university departments of obstetrics and gynecology in Italy.
POPULATION:
Seventy-eight women who underwent laparoscopic surgery for endometriosis combined with chronic pelvic pain.
METHODS:
Post-operative administration of dienogest + E2V for 9 months (group 1) or GnRH-a monthly for 6 months (group 2).
MAIN OUTCOME MEASURES:
A visual analogue scale was used to test intensity of pain before laparoscopic surgery at 3, 6 and 9 months of follow up. A questionnaire to investigate quality of life was administered before surgery and at 9 months of follow up.
RESULTS:
The visual analogue scale score did not show any significant differences between the two groups (p = 0.417). The questionnaire showed an increase of scores for all women compared with pre-surgery values, demonstrating a marked improvement in quality of life and health-related satisfaction with both treatments. No significant differences were found between the groups. The rate of apparent endometriosis recurrence was 10.8% in group 1 and 13.7% in group 2 (p = 0.962).
CONCLUSION:
Both therapies seemed equally efficacious in preventing endometriosis-related chronic pelvic pain recurrence in the first 9 months of follow-up.
AuthorsRoberta Granese, Antonino Perino, Gloria Calagna, Salvatore Saitta, Pasquale De Franciscis, Nicola Colacurci, Onofrio Triolo, Gaspare Cucinella
JournalActa obstetricia et gynecologica Scandinavica (Acta Obstet Gynecol Scand) Vol. 94 Issue 6 Pg. 637-45 (Jun 2015) ISSN: 1600-0412 [Electronic] England
PMID25761587 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
Copyright© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.
Chemical References
  • estradiol valerate-dienogest
  • Gonadotropin-Releasing Hormone
  • Estradiol
  • Nandrolone
Topics
  • Adolescent
  • Adult
  • Endometriosis (surgery)
  • Estradiol (analogs & derivatives, therapeutic use)
  • Female
  • Gonadotropin-Releasing Hormone (analogs & derivatives)
  • Humans
  • Italy
  • Laparoscopy
  • Middle Aged
  • Nandrolone (analogs & derivatives, therapeutic use)
  • Pain Management
  • Pain Measurement
  • Pelvic Pain (etiology, prevention & control)
  • Prospective Studies
  • Quality of Life
  • Recurrence
  • Surveys and Questionnaires

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