Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Abstract

OBJECTIVE:

The primary aim of the study was to analyze the endometrioma recurrence rate in patients who underwent laparoscopic excision followed by postoperative long-term regimen of oral contraceptives (OCs).

MATERIALS AND METHODS:

168 patients who underwent a conservative laparoscopic surgery for endometrioma, during the period between September 2009 and August 2010 in three university hospitals were studied. A long-term OCs therapy was offered to all women following surgery. Patients were randomly divided into three groups according to different progestins used (desogestrel, gestodene, dienogest). Women who refused a postoperative hormonal therapy served as control. Follow-up visits and transvaginal scan were planned at 1, 3, 6, 12, and 24 months after surgery. All patients who showed an ultrasound persistence of the endometrioma at 1 month follow-up were excluded from clinical analysis.

RESULTS:

Of the 168 patients, 131 completed the 24 months follow-up. Endometrioma recurrence was found in 21 (12.5 %) of all patients, it was unilateral in 17 cases while bilateral in 4 cases. The rate of recurrent endometrioma was statistically significant in non-users compared to the long-term OCs treated patients.

CONCLUSION:

The current data suggest the usefulness of long-term OCs regimen after conservative surgery for the prevention of ovarian endometrioma recurrence. As a statistical significant difference could not be observed between OCs groups, further study on the individual molecules is required in order to really understand the effect of each of them.

• Authors: Gaspare Cucinella, Roberta Granese, Gloria Calagna, Alessandro Svelato, Salvatore Saitta, Gabriele Tonni, Pasquale De Franciscis, Nicola Colacurci, Antonino Perino
• Journal: Archives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 288 Issue 4 Pg. 821-7 (Oct 2013) ISSN: 1432-0711 [Electronic] Germany
• PMID: 23580011 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Contraceptives, Oral
• Norpregnenes
• Gestodene
• dienogest
• Nandrolone
• Desogestrel

Topics

• Adolescent
• Adult
• Combined Modality Therapy
• Contraceptives, Oral (therapeutic use)
• Desogestrel (therapeutic use)
• Drug Administration Schedule
• Endometriosis (prevention & control, surgery)
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Laparoscopy
• Nandrolone (analogs & derivatives, therapeutic use)
• Norpregnenes (therapeutic use)
• Ovarian Diseases (prevention & control, surgery)
• Secondary Prevention
• Treatment Outcome
• Young Adult