Impact of GnRH agonist treatment on recurrence of ovarian endometriomas after conservative laparoscopic surgery

Objective To analyze the influence of postoperative GnRH agonist treatment on disease recurrence after conservative laparoscopic surgery for ovarian endometriomas according to duration of the treatment. Design Retrospective cohort study. Setting University hospital. Patient(s) One hundred nine conse...

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Bibliographic Details
Published in:Fertility and sterility 2009, Vol.91 (1), p.40-45
Main Authors: Jee, Byung Chul, M.D, Lee, Joong Yeup, M.D, Suh, Chang Suk, M.D, Kim, Seok Hyun, M.D, Choi, Young Min, M.D, Moon, Shin Yong, M.D
Format: Article
Language:English
Subjects:
Biological and medical sciences
Combined Modality Therapy
endometrioma
Endometriosis
Endometriosis - drug therapy
Endometriosis - surgery
Female
Female genital diseases
Follow-Up Studies
Gonadotropin-Releasing Hormone - agonists
gonadotropin-releasing hormone agonist
Gynecologic Surgical Procedures
Gynecology. Andrology. Obstetrics
Humans
Internal Medicine
Korea
Laparoscopy
Medical sciences
Non tumoral diseases
Obstetrics and Gynecology
Probability
Recurrence
Time Factors
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Summary:Objective To analyze the influence of postoperative GnRH agonist treatment on disease recurrence after conservative laparoscopic surgery for ovarian endometriomas according to duration of the treatment. Design Retrospective cohort study. Setting University hospital. Patient(s) One hundred nine consecutive premenopausal women who underwent conservative laparoscopic surgery for ovarian endometriomas (endometriosis stage III/IV) were enrolled in the study. The patients were divided into four treatment groups: expectant management (n = 37) and GnRH agonist therapy for 3 (n = 28), 4 (n = 21), and 6 months (n = 23). Intervention(s) None. Main Outcome Measure(s) An ultrasound confirmed recurrence of ovarian endometriomas. Result(s) The overall crude recurrence rate was 16.5% after follow-up for an average of 20.1 months. The crude recurrence and the cumulative probabilities of disease recurrence at 24/36 months tended to be lower in patients who received a GnRH agonist for 6 months (4.3%, 5.3%/5.3%) compared with those who received it for 3 months (17.9%, 12.5%/25.0%) and 4 months (28.6%, 18.9%/39.2%) and patients with expectant management (16.2%, 22.4%/37.9%). However, the differences did not reach statistical significance. Conclusion(s) Treatment with GnRH agonist for six months had a beneficial impact on the recurrence rate after conservative laparoscopic surgery for ovarian endometriomas.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2007.11.027