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Email this article Effectiveness of Combined Surgical and Hormonal Therapy in the Prevention of Recurrences of Endometriomas
Abstract
Introduction: Endometrial cyst, or endometrioma develops in the ovaries and is characterized by the presence of the tissue similar to endometrium and forms cysts within the ovary. High rate of recurrence after surgical intervention presents a significant challenge in the management of this disease.
Aim of the study: Aim of the study was to determine the effectiveness of surgical and combined (surgical and hormone therapy) therapy of endometrioma in terms of development of recurrences.
Material and methods: Study group consisted of 260 patients with endometrioma who underwent laparoscopic intervention with enucleation of endometrial cyst. Observation was carried out in the period up to 5 years after the surgical intervention. The study group was divided into the following groups: Group I - patients who were treated after surgical intervention with dienogest for 6 months continuously (n-57); Group II - patients who after surgical intervention were treated with combined contraceptives (COC) for 6 months cyclically 21 days from the 5th day of menstrual cycle (n-61); Group III - patients who after surgical intervention were treated with dydrogesterone for 6 months, cyclically 10 days from the 16th day of the menstrual cycle (n-44); Group IV - control group, patients who did not undergo postoperative drug treatment (n-98).
Results: At 5-year post-operative follow-up after treatment with Dienogest and Dydrogesterone, recurrence of endometrial cyst did not develop in any case, recurrence after administration of COC was observed in only 1 case (1.6%), and the rate of recurrence in the control group was 18.2% (n-18), P<0.01 , which is significantly higher compared to patients in each group of hormone therapy, however, no significant difference between the groups of hormone therapy was detected in terms of the development of recurrence (P>0.05).
Conclusion: After surgical treatment of endometrioma, in cases of using different hormonal drugs (Dienogest, COC, Dydrogesterone), the rate of recurrence of endometrioma is significantly low compared to treatment with surgical intervention only, and when assessing the effectiveness of individual hormonal medications (Dienogest, COC, Dydrogesterone) no significant difference was found in the rate of development of reccurencies.Keywords
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