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Gonadotropin-releasing hormone agonist with add–back treatment is as effective and tolerable as dienogest in preventing pain recurrence after laparoscopic surgery for endometriosis

  • General Gynecology
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Abstract

Purpose

This study was performed to compare the efficacy and tolerability of GnRH agonist with add–back therapy versus dienogest treatment for preventing pelvic pain recurrence after laparoscopic surgery for endometriosis.

Methods

Sixty-four reproductive-aged women who underwent laparoscopic surgery for endometriosis received post-operative medical treatment with either GnRH agonist plus 17β-estradiol and norethisterone acetate (n = 28) or dienogest (n = 36) for 6 months. The pre- to post-treatment changes in pain were assessed using a visual analogue scale, and changes in quality-of-life and menopausal symptoms were measured by questionnaire.

Results

Visual analogue scale pain score decreased significantly for both treatments with no significant differences between groups. Neither physical, psychological, social, and environmental components of quality-of-life nor menopausal rating scale score were significantly different between the two groups. Bone mineral density at the lumbar spine declined significantly in both treatment groups (−2.5 % for GnRH agonist plus add–back and −2.3 % for dienogest), with no significant difference between the two groups.

Conclusion

GnRH agonist and add–back therapy using 17β-estradiol and norethisterone acetate are as effective and tolerable as dienogest for the prevention of pelvic pain recurrence after laparoscopic surgery for endometriosis.

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Author notes

    Authors and Affiliations

    1. Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea

      Dong-Yun Lee, Jee-Yeon Lee, Jong-Wook Seo, Byung-Koo Yoon & DooSeok Choi

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    1. Dong-Yun Lee
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    2. Jee-Yeon Lee
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    3. Jong-Wook Seo
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    4. Byung-Koo Yoon
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    5. DooSeok Choi
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    Correspondence to DooSeok Choi.

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    Conflict of interest

    DYL declares that he has no conflict of interest. JYL declares that she has no conflict of interest. JWS declares that he has no conflict of interest. BKY declares that he has no conflict of interest. DC declares that he has no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individual participants included in this study.

    Additional information

    D.-Y. Lee and J.-Y. Lee contributed equally to this work.

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    Lee, DY., Lee, JY., Seo, JW. et al. Gonadotropin-releasing hormone agonist with add–back treatment is as effective and tolerable as dienogest in preventing pain recurrence after laparoscopic surgery for endometriosis. Arch Gynecol Obstet 294, 1257–1263 (2016). https://doi.org/10.1007/s00404-016-4184-9

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    • DOI: https://doi.org/10.1007/s00404-016-4184-9

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