Long-term hormonal treatment reduces repetitive surgery for endometriosis recurrence |
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Authors: | Tommaso Capezzuoli Silvia Vannuccini Daniele Mautone Flavia Sorbi Huixi Chen Fernando M Reis Marcello Ceccaroni Felice Petraglia |
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Institution: | 1. Department of Clinical Experimental and Biomedical Sciences, University of Florence Florence, Italy;2. Obstetrics and Gynecology, Department of Maternity and Infancy, AOU Careggi Florence, Italy;3. Department of Molecular and Developmental Medicine, University of Siena Siena, Italy;4. Gynecology and Obstetrics, Gynecologic Oncology, Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacro Cuore Don Calabria Hospital, Negar di Valpolicella, Verona, Italy;5. International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, China;6. Universidade Federal de Minas Gerais, Division of Human Reproduction, Belo Horizonte, Brazil |
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Abstract: | Research questionHow effective is medical hormonal treatment in preventing endometriosis recurrence and in improving women's clinical symptoms and quality of life?DesignThis observational cross-sectional study evaluated the effects of hormonal medical treatment (progestins, gonadotrophin-releasing hormone analogues or continuous oral contraceptives) on endometriosis recurrence, current clinical symptoms and quality of life in three groups of patients: Group A (n = 34), no hormonal treatment either before or after the first endometriosis surgery; Group B (n = 76), on hormonal treatment after the first endometriosis surgery; and Group C (n = 75), on hormonal treatment both before and after the first endometriosis surgery.ResultsGroup C patients were characterized by a lower rate of endometriosis reoperation (P = 0.011) and a lower rate of dysmenorrhoea (P = 0.006). Women who experienced repetitive endometriosis surgery showed worse physical (P = 0.004) and mental (P = 0.012) status than those who received a single surgery, independent of the treatment.ConclusionHormonal treatments represent a valid cornerstone of endometriosis management and may be useful as an alternative to surgery, but also before surgery, to plan better, and after surgery in order to reduce the risk of recurrence. Medical counselling is very helpful in choosing the correct and individualized endometriosis treatment. In fact, the gold standard for modern endometriosis management is the individualized approach and surgery should be considered, depending on the clinical situation and a patient's symptoms. |
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