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Postoperative administration of dienogest plus estradiol valerate versus levonorgestrel‐releasing intrauterine device for prevention of pain relapse and disease recurrence in endometriosis patients
Author(s) -
Morelli Michele,
Sacchinelli Angela,
Venturella Roberta,
Mocciaro Rita,
Zullo Fulvio
Publication year - 2013
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12030
Subject(s) - dienogest , medicine , levonorgestrel , endometriosis , estradiol valerate , pelvic pain , progestin , intrauterine device , clinical endpoint , urology , surgery , gynecology , randomized controlled trial , estrogen , population , family planning , environmental health , research methodology
Aim In recent years, both dienogest, a fourth‐generation progestin, and levonorgestrel‐releasing intrauterine device have been found to be effective in terms of endometriosis‐related pelvic pain improvement. No data, however, are available about their efficacy in terms of postoperative recurrence prevention in women recently submitted to surgery for endometriosis at every stage. Our objective was to compare two postoperative medical approaches for pain control and reduction of recurrences in patients undergoing surgery for endometriosis. Material and Methods Ninety‐two patients undergoing surgery for endometriosis and subsequent treatment by estradiol valerate + dienogest ( EP ) (group A ) or levonorgestrel‐releasing uterine device ( LNG‐IUD ) (Group B ) between J anuary 2009 and J une 2010 were retrospectively analyzed. The primary endpoints were pain relapse and disease recurrence rate at 12 and 24 months. The secondary endpoint was patient satisfaction with the therapy at 24 months. Results Forty‐eight patients in Group A and 44 in Group B were examined. At 12 and 24 months a statistically greater reduction both in Ca125 levels and VAS score was seen in women treated with EP compared to LNG‐IUD . The recurrence rate at 12 and 24 months follow‐up was slightly lower, but not at a significant level, in Group A than in Group B . Finally, satisfaction with treatment at 24 months was significantly higher in Group B . Conclusion EP administration is significantly more effective than LNG‐IUD in reducing pelvic pain and more effective in reducing recurrence rate but not at a significant level. LNG‐IUD , however, has significantly higher patient satisfaction.