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Published in: Advances in Therapy 6/2018

01-06-2018 | Brief Report

Comparison of Outcomes of Different Postoperative Hormone Therapy in the Treatment of Ovarian Endometriosis: A Brief Report

Authors: Songnan Zhu, Yingjun Zhu, Yabo Liu, Hong Zhang

Published in: Advances in Therapy | Issue 6/2018

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Abstract

Introduction

Hormone therapy is widely used in the treatment of patients with ovarian endometriosis after surgery, and progestin and gonadotropin-releasing hormone (GnRH) are two of the most widely used hormones. This study aimed to compare the outcomes of progestin and GnRH in the treatment of ovarian endometriosis after surgery.

Methods

A total of 399 patients with ovarian endometriosis were included and divided into four groups to receive different treatments. Group A received no postoperative hormone therapy; patients in group B1 and B2 were treated with different doses of norethindrone (progestin, 1.2 and 5 mg/day, respectively); patients in group C were treated with GnRH (2.0 mg every 2 weeks). Treatment outcomes including menstrual bleeding profiles, cumulative recurrence rate, incidence of complications, and endometrioma diameter in the case of recurrence were recorded and compared between groups.

Results

Compared with group A, group B1, B2 and C showed significantly improved menstrual bleeding profiles and reduced cumulative recurrence rate and endometrioma diameter after recurrence. In addition, compared with group C, menstrual bleeding profiles were significantly improved and cumulative recurrence rate and endometrioma diameter were significantly reduced in group B1 and B2. No significant differences in incidence of complications during treatment were found among groups. After treatment, recurrence rate and endometrioma diameter were significantly increased in group B1, B2, and C.

Conclusion

Both progestin and GnRH can significantly improve the conditions of patients with ovarian endometriosis after surgery, but progestin may be a better choice. Both therapies are challenged by the increased recurrence rate and endometrioma diameter after treatment.
Literature
1.
go back to reference Vercellini P, Viganò P, Somigliana E, et al. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10(5):261–75.CrossRefPubMed Vercellini P, Viganò P, Somigliana E, et al. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10(5):261–75.CrossRefPubMed
2.
go back to reference Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 1997;68(4):585–96.CrossRefPubMed Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 1997;68(4):585–96.CrossRefPubMed
4.
go back to reference Duffy JM, Arambage K, Correa FJ, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev. 2014;(4)CD011031. Duffy JM, Arambage K, Correa FJ, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev. 2014;(4)CD011031.
5.
go back to reference 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. 2013;288(4):821–7.CrossRefPubMed 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. 2013;288(4):821–7.CrossRefPubMed
6.
go back to reference Somigliana E, Vercellini P, Vigano P, et al. Postoperative medical therapy after surgical treatment of endometriosis: from adjuvant therapy to tertiary prevention. J Minim Invasive Gynecol. 2014;21(3):328–34.CrossRefPubMed Somigliana E, Vercellini P, Vigano P, et al. Postoperative medical therapy after surgical treatment of endometriosis: from adjuvant therapy to tertiary prevention. J Minim Invasive Gynecol. 2014;21(3):328–34.CrossRefPubMed
7.
go back to reference Surrey ES, Katz-Jaffe M, Kondapalli LV, et al. GnRH agonist administration prior to embryo transfer in freeze-all cycles of patients with endometriosis or aberrant endometrial integrin expression. Reprod BioMed Online. 2017;35(2):145–51. Surrey ES, Katz-Jaffe M, Kondapalli LV, et al. GnRH agonist administration prior to embryo transfer in freeze-all cycles of patients with endometriosis or aberrant endometrial integrin expression. Reprod BioMed Online. 2017;35(2):145–51.
8.
go back to reference Shao R, Cao S, Wang X, et al. The elusive and controversial roles of estrogen and progesterone receptors in human endometriosis. Am J Transl Res. 2014;6(2):104.PubMedPubMedCentral Shao R, Cao S, Wang X, et al. The elusive and controversial roles of estrogen and progesterone receptors in human endometriosis. Am J Transl Res. 2014;6(2):104.PubMedPubMedCentral
9.
go back to reference The American Fertility Society. Revised American Fertility Society classification of ovarian endometriosis. Fertil Steril. 1985;43:351–2.CrossRef The American Fertility Society. Revised American Fertility Society classification of ovarian endometriosis. Fertil Steril. 1985;43:351–2.CrossRef
10.
go back to reference Nnoaham KE, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96(2):366–73.e8. Nnoaham KE, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96(2):366–73.e8.
11.
go back to reference Rogers PAW, D’Hooghe TM, Fazleabas A, et al. Priorities for endometriosis research: recommendations from an international consensus workshop. Reprod Sci. 2009;16(4):335–46.CrossRefPubMedPubMedCentral Rogers PAW, D’Hooghe TM, Fazleabas A, et al. Priorities for endometriosis research: recommendations from an international consensus workshop. Reprod Sci. 2009;16(4):335–46.CrossRefPubMedPubMedCentral
12.
go back to reference Zhao L, Yang H, Xuan Y, et al. Increased expression of fibroblast growth factor receptor 1 in endometriosis and its correlation with endometriosis-related dysmenorrhea and recurrence. Eur J Obstet Gynecol Reprod Biol. 2015;184:117–24.CrossRefPubMed Zhao L, Yang H, Xuan Y, et al. Increased expression of fibroblast growth factor receptor 1 in endometriosis and its correlation with endometriosis-related dysmenorrhea and recurrence. Eur J Obstet Gynecol Reprod Biol. 2015;184:117–24.CrossRefPubMed
13.
go back to reference Chapron C, Fauconnier A, Dubuisson JB, et al. Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and extent of disease. Hum Reprod. 2003;18(4):760–6.CrossRefPubMed Chapron C, Fauconnier A, Dubuisson JB, et al. Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and extent of disease. Hum Reprod. 2003;18(4):760–6.CrossRefPubMed
14.
go back to reference Wardle J. Endometriosis and menorrhagia. In: Sarris J, Wardle J, editors. Clinical naturopathy: in practice. Chatswood: Elsevier; 2017. p. 110. Wardle J. Endometriosis and menorrhagia. In: Sarris J, Wardle J, editors. Clinical naturopathy: in practice. Chatswood: Elsevier; 2017. p. 110.
15.
go back to reference Sriprasert I, Beydoun H, Barnabei V, et al. Incidence of endometrial spotting or bleeding during continuous-combined estrogen-progestin therapy in postmenopausal women with and without hypertension. Menopause. 2015;22(10):1067–75.CrossRefPubMed Sriprasert I, Beydoun H, Barnabei V, et al. Incidence of endometrial spotting or bleeding during continuous-combined estrogen-progestin therapy in postmenopausal women with and without hypertension. Menopause. 2015;22(10):1067–75.CrossRefPubMed
16.
go back to reference Wu B, Yang Z, Tobe RG, Wang Y. Medical therapy for preventing recurrent endometriosis after conservative surgery: a cost-effectiveness analysis. BJOG. 2018;125(4):469–77. Wu B, Yang Z, Tobe RG, Wang Y. Medical therapy for preventing recurrent endometriosis after conservative surgery: a cost-effectiveness analysis. BJOG. 2018;125(4):469–77.
17.
go back to reference Zheng Q, Mao H, Xu Y, et al. Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis. Arch Gynecol Obstet. 2016;294(1):201–7.CrossRefPubMed Zheng Q, Mao H, Xu Y, et al. Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis. Arch Gynecol Obstet. 2016;294(1):201–7.CrossRefPubMed
18.
go back to reference Ouchi N, Akira S, Mine K, et al. Recurrence of ovarian endometrioma after laparoscopic excision: risk factors and prevention. J Obstet Gynaecol Res. 2014;40(1):230–6.CrossRefPubMed Ouchi N, Akira S, Mine K, et al. Recurrence of ovarian endometrioma after laparoscopic excision: risk factors and prevention. J Obstet Gynaecol Res. 2014;40(1):230–6.CrossRefPubMed
19.
go back to reference Lee SY, Kim ML, Seong SJ, et al. Recurrence of ovarian endometrioma in adolescents after conservative, laparoscopic cyst enucleation. J Pediatr Adolesc Gynecol. 2017;30(2):228–33.CrossRefPubMed Lee SY, Kim ML, Seong SJ, et al. Recurrence of ovarian endometrioma in adolescents after conservative, laparoscopic cyst enucleation. J Pediatr Adolesc Gynecol. 2017;30(2):228–33.CrossRefPubMed
20.
go back to reference Brosens I, Gordts S, Puttemans P, et al. Pathophysiology proposed as the basis for modern management of the ovarian endometrioma. Reprod BioMed Online. 2014;28(2):232–8.CrossRefPubMed Brosens I, Gordts S, Puttemans P, et al. Pathophysiology proposed as the basis for modern management of the ovarian endometrioma. Reprod BioMed Online. 2014;28(2):232–8.CrossRefPubMed
Metadata
Title
Comparison of Outcomes of Different Postoperative Hormone Therapy in the Treatment of Ovarian Endometriosis: A Brief Report
Authors
Songnan Zhu
Yingjun Zhu
Yabo Liu
Hong Zhang
Publication date
01-06-2018
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 6/2018
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-018-0715-z

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