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Dienogest compared with gonadotropin‐releasing hormone agonist after conservative surgery for endometriosis
Author(s) -
Takaesu Yotaro,
Nishi Hirotaka,
Kojima Junya,
Sasaki Toru,
Nagamitsu Yuzo,
Kato Rina,
Isaka Keiichi
Publication year - 2016
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.13023
Subject(s) - dienogest , medicine , goserelin , danazol , endometriosis , progestin , urology , gonadotropin releasing hormone agonist , pelvic pain , gynecology , estrogen , hormone , surgery , gonadotropin releasing hormone , breast cancer , luteinizing hormone , cancer
Aim Although there are various hormone therapies, including gonadotropin‐releasing hormone agonist, danazol, levonorgestrel‐releasing intrauterine system, dienogest, and low‐dose estrogen progestin, no consensus opinion has been reached in terms of which medication should be used and for how long it should be administered. We aimed to determine whether dienogest or goserelin is the better postoperative therapy to prevent recurrence of endometriosis. Methods A prospective cohort randomized study were conducted, including 198 patients diagnosed as having endometriosis. A total of 111 patients were randomly assigned into two groups: the dienogest‐administered group ( n = 56) and the goserelin‐administered group ( n = 55). Patients were followed for 24 months after laparoscopic surgery. Those who gave consent but desired no postoperative therapy were assigned to the non‐treatment group ( n = 79). Recurrence, side‐effects, degrees of menstrual pain and chronic pelvic pain measured by the Visual Analogue Scale were compared among the three groups: the dienogest, goserelin, and non‐treatment groups. Results No significant difference was observed in the postoperative recurrence rate between the dienogest and goserelin groups. No significant difference was found in the recurrence rate between the goserelin group and non‐treatment group; however, a significant difference was found in the recurrence rate between the dienogest group and the non‐treatment group ( P = 0.027). Menstrual pain and chronic pelvic pain were significantly improved in both treatment groups. Side‐effects were markedly observed in the goserelin group as compared with the dienogest group. Conclusion Dienogest is available for prolonged administration of more than 6 months, so it is more useful than goserelin, which is available only for short‐term administration.