Long-term follow-up on the treatment of endometriosis with the GnRH-agonist buserelinacetate. Long-term follow-up data (up to 98 months) of 42 patients with endometriosis who were treated with GnRH-agonist buserelinacetate (Suprecur), were evaluated in respect of recurrence of pain symptoms and pregnancy outcome.
OBJECTIVE
In our previous study, 119 patients with histologically confirmed endometriosis underwent a 'three-step' therapy between 1987 and 1989, where surgical removal of endometriosis was followed by a 6 month treatment with 3 x 300 microgram buserelinacetate daily intranasally and a second look laparoscopy or laparotomy with removal of residuals. Long-term follow-up data in respect of recurrence of symptoms and pregnancy outcome were investigated.


METHODS
Long-term follow-up data of 42 out of 119 treated patients on the post-treatment effect were obtained using a special questionnaire. Recurrence of dysmenorrhea, dyspareunia and pelvic pain was defined as recurrence of disease. The follow-up period was up to 98 months with a median time of 82.5 months.


RESULTS
Out of the 42 patients, 23 complained of infertility. Fourteen out of these 23 patients became pregnant during the follow-up period, resulting in 23 pregnancies with 18 newborns, 4 miscarriages and one ectopic pregnancy. Ten patients conceived spontaneously, stimulation program became necessary in the rest of patients. Twenty-eight of the 42 patients complained recurrence of symptoms with median first onset at 10.7 months. Improvement on quality of life and subjective conditions were reported by 30 patients.


CONCLUSIONS
Our study suggests that the 'three-step' therapy of endometriosis with GnRH-agonist buserelinacetate leads to a significant improvement on the quality of life and well being in the majority of the patients and to a high pregnancy rate. This treatment represents a favourable approach in the management of endometriosis.
Regidor
P A
PA
Department of Gynecology, University of Essen, Germany.
Regidor
M
M
Kato
K
K
Bier
U W
UW
Bühler
K
K
Schindler
A E
AE
D000328:Adult; D002064:Buserelin / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy* / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000188:drug therapy; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011966:Receptors, LHRH / Q000819:agonists*; D012008:Recurrence; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D011966:Receptors, LHRH; D002064:Buserelin