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Exploratory study of pre‐surgical medications with dienogest or leuprorelin in laparoscopic cystectomy of endometrial cysts
Author(s) -
Takenaka Motoki,
Yano Ryuichiro,
Hiraku Yuka,
Shibata Mayuko,
Hatano Kayoko,
Yamamoto Shiori,
Sato Kazuki,
Yamamoto Kazushige,
Morishige Kenichiro
Publication year - 2015
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.12701
Subject(s) - medicine , leuprorelin , dienogest , laparoscopy , endometriosis , laparoscopic surgery , urology , hysterectomy , visual analogue scale , surgery , gynecology , luteinizing hormone , hormone , gonadotropin releasing hormone
Aim The aim of this study was to compare the effects of pre‐surgical medication with dienogest or leuprorelin on post‐surgical ovarian function. Material and Methods We conducted an exploratory study in two centers in Japan that comprised 30 patients with ovarian endometrial cysts for whom surgical excision was planned. Patients were enrolled and divided into pre‐surgical medication groups with dienogest or leuprorelin for 12 weeks. Thereafter, patients were treated by laparoscopic cystectomy. The primary outcome was ovarian function post‐surgery, as assessed by serum anti‐Müllerian hormone (AMH) level, antral follicle count (AFC) and resumption of menses. Secondary outcome was the effect of pre‐surgical medication, as assessed by the size of endometrial cysts and visual analog scale (VAS) score. Serum AMH, AFC, size of endometrial cysts, and VAS scores were measured at baseline (before medication), after medication (1 day before surgery), and at 4 and 12 weeks post‐surgery. Results Serum AMH levels did not change after pre‐surgical medication with either dienogest or leuprorelin. Although AMH decreased after surgery, it recovered by 12 weeks post‐surgery in both groups with no statistically significant difference. Mean AFC did not change after surgery in either group. Menses returned by 12 weeks post‐surgery in all patients except for those who were pregnant. The rate of reduction of endometrial cyst volume did not differ between the groups. Both dienogest and leuprorelin were associated with substantial reductions in VAS scores. Conclusion There were no statistically significant differences between pre‐surgical medication with dienogest and leuprorelin in post‐surgical ovarian function. Both medications were effective in reducing endometrial cyst volume and VAS score.