Post-operative use of oral contraceptive pills for prevention of anatomical relapse or symptom-recurrence after conservative surgery for endometriosis

Seracchioli, Renato; Mabrouk, Mohamed; Manuzzi, Lisa; Vicenzi, Claudia; Frascà, Clarissa; Elmakky, Amira; Venturoli, Stefano

doi:10.1093/humrep/dep259

Cited by 125 publications

(66 citation statements)

References 28 publications

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“…Some studies have reported that monophasic oral contraceptive treatment either to reduce retrograde menstrual cycles or to inhibit ovulation-which are both considered etiopathogenetic factors for endometriosis-may also suppress the recurrence of endometrioma when administered long term after conservative surgery [2,5,10,16,23]. Progestogens have a crucial role in decreasing endometriotic lesions, through a number of mechanisms which may vary in type and intensity according to the different molecules.…”

Section: Introductionmentioning

confidence: 99%

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

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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Objective The primary aim of the study was to analyze the endometrioma recurrence rate in patients who underwent laparoscopic excision followed by postoperative longterm 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.

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Section: Introductionmentioning

confidence: 99%

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

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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“…(24) Our result supported the evidence that chronic pelvic pain related to endometriosis may respond partially to anti-prostaglandins and oral contraceptive pills, the facts proved by others. (25,26) In our study, the responds rate to NSAIDS and hormonal therapy was 31.3%. Studies have shown that if these agents are refractory, endometriosis is diagnosable in 50% to 70% of these patients.…”

Section: Discussionmentioning

confidence: 47%

Prevalence of Endometriosis among Adolescent School Girls with Severe Dysmenorrhea : A Cross Sectional Prospective Study

Shams

Badawy

Alsammani

2015

IJHS

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Abstract:Objectives: To determine the prevalence of endometriosis among adolescent school girls with severe dysmenorrhea. Methodology:Data was collected via interviewed questionnaire. Patients with symptoms and signs suggestive of endometriosis were further evaluated by abdominal ultrasonography (AUS), serum cancer antigen 125 (CA125). Laparoscopy was done for confirmation in those who agreed. Those who declined laparoscopy were offered magnetic resonance imaging (MRI).Results: A total number of 654 adolescents were interviewed. Their mean age was 15.2 ±3.53 SD years. The mean duration of cycles and flow days was 29 ± 8.4 SD and 4 ± 2.8 SD respectively. The age of menarche in years was 13 ± 1.2 SD. Cycles were regular in 77.4 % (n=506) while irregular in 22.6 % (n=148). Of all studied girls, 48.9% (n=320) had menstrual pain of varying degree of severity. Severe dysmenorrhea was reported in 68.8 % (n=220/320) of them. Fifty six of these cases (25.5 %) had ultrasound findings suggestive of endometriosis. CA125 was elevated in41.5 % (n= 27/56) of them. Patients accepted laparoscopic confirmations were 34, of them 79.4%, (n=27) had positive histo-pathological evidence of endometriosis. MRI was offered to those declined laparoscopy (n=22). Endometriosis was suggested in 77.3% of them. Conclusion:The study concluded the prevalence of endometriosis in adolescents with severe dysmenorrhea was 12.3 % despite some declined laparoscopy. The unacceptability of laparoscopy and unfeasibility of local examination and trans-vaginal ultrasound add more to the difficulty of diagnosis.

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“…Conservative surgical procedures like adhesiolysis and removal of endometriotic cysts with post-operative medical therapy with OCP for more than a year can give longer duration of pain relief and delay the anatomical recurrence rates. [16][17][18][19] The studies in the Table 8 include observational studies, randomized controlled studies and non-randomized studies.…”

Section: Discussionmentioning

confidence: 99%

Study of endometriosis in women of reproductive age, laparoscopic management and its outcome

Valson

Kulkarni

Teli

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Post-operative use of oral contraceptive pills for prevention of anatomical relapse or symptom-recurrence after conservative surgery for endometriosis

Cited by 125 publications

References 28 publications

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

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

Prevalence of Endometriosis among Adolescent School Girls with Severe Dysmenorrhea : A Cross Sectional Prospective Study

Study of endometriosis in women of reproductive age, laparoscopic management and its outcome

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