Pre or post-operative medical treatment with nafarelin in stage III-IV endometriosis: a French multicenter study.
OBJECTIVE
To determine the effectiveness of a 6-month course of nafarelin in the treatment of stage III-IV endometriosis and to determine if pre-operative use of nafarelin facilitates surgery.


METHODS
Prospective, multicenter, clinical trial.


METHODS
Eight university hospitals and two private practice institutions in France.


METHODS
Fifty-five patients with stage III and IV endometriosis. Two were excluded.


METHODS
The severity of endometriosis was assessed at the time of laparoscopy and patients were randomized to have either laparosopic surgery at that time following 6 months of nafarelin therapy (n=28), or laparoscopic surgery following 6 months of nafarelin therapy (n=25). All had 200 microg intranasal nafarelin twice a day for 6 months and a second look laparoscopy.


METHODS
Clinical efficacy, tolerance to the treatment.


RESULTS
Efficacy and tolerance to the treatment were the same in both groups. AFS scores compared on both laparoscopies were significantly better if nafarelin was given prior to surgery (P=0.007).


CONCLUSIONS
This preliminary study shows that in cases of combined medico-surgical treatment for stage III-IV endometriosis, preoperative medical treatment with GnRH-a gives a better AFS score improvement, but no conclusion was possible whether preoperative treatment facilitates surgery.
Audebert
A
A
Institut Greenblatt France, Bordeaux.
Descamps
P
P
Marret
H
H
Ory-Lavollee
L
L
Bailleul
F
F
Hamamah
S
S
D000328:Adult; D004311:Double-Blind Method; D004715:Endometriosis / Q000188:drug therapy*; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy; D017274:Nafarelin / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies
D006728:Hormones; D017274:Nafarelin