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

  • General Gynecology
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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.

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Conflict of interest

The authors declare to have no financial relationship with any organization or Companies. Authors also declare to have had full control of all primary data and that all coauthors agree to allow the journal to review their data if requested.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Hospital ‘‘Paolo Giaccone’’, Palermo, Italy

    Gaspare Cucinella, Gloria Calagna, Alessandro Svelato & Antonino Perino

  2. Department of Obstetrics and Gynecology, University Hospital ‘‘Gaetano Martino’’, Messina, Italy

    Roberta Granese, Salvatore Saitta & Pasquale De Franciscis

  3. Department of Obstetrics and Gynecology, Guastalla Civil Hospital, AUSL Reggio Emilia, Via Donatori Sangue, 2, 42016, Guastalla, Reggio Emilia, Italy

    Gabriele Tonni

  4. Department of Obstetrics, Gynecology, and Reproductive Sciences, Second University of Naples, Naples, Italy

    Nicola Colacurci

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  1. Gaspare Cucinella
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  2. Roberta Granese
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  4. Alessandro Svelato
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  6. Gabriele Tonni
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  9. Antonino Perino
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Corresponding author

Correspondence to Gabriele Tonni.

Additional information

G. Cucinella and R. Granese are equal first authors.

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Cucinella, G., Granese, R., Calagna, G. et al. Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?. Arch Gynecol Obstet 288, 821–827 (2013). https://doi.org/10.1007/s00404-013-2841-9

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  • DOI: https://doi.org/10.1007/s00404-013-2841-9

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