An open and randomized study comparing the efficacy of standard danazol and modified triptorelin regimens for postoperative disease management of moderate to severe endometriosis.
OBJECTIVE
To compare the efficacy of danazol and triptorelin (Decapeptyl CR, Ferring, Kiel, Germany) in the management of moderate and severe endometriosis in terms of symptom control and revised American Fertility Society (AFS) score reduction, and to evaluate the hormonal profile of patients treated with triptorelin every 6 weeks.


METHODS
Open and randomized trial.


METHODS
Kwong Wah Hospital, a large public hospital in an urban location (Hong Kong).


METHODS
Forty patients after their first conservative operation for endometriosis, with surgical confirmation of revised AFS stage III or IV endometriosis.


METHODS
Postoperative 6 months' therapy of danazol or triptorelin every 6 weeks, postmedical therapy second-look laparoscopy.


METHODS
Symptom control and patients' tolerance during medical therapy, posttherapy revised AFS score, hormonal profile during triptorelin therapy.


RESULTS
Pain control was similar between danazol and triptorelin therapy. There was less breakthrough bleeding with triptorelin. More patients failed to complete the whole course of danazol because of its side effects. The revised AFS score at second-look laparoscopy did not show a significant difference between the two medications. Adequate pituitary suppression was observed with injection of triptorelin every 6 weeks.


CONCLUSIONS
Lengthening of triptorelin administration intervals from 4 weeks to 6 weeks is effective in maintaining a hypoestrogenic state. Patients were more compliant with triptorelin than danazol. Thus, triptorelin injection every 6 weeks is more cost-effective than conventional regimens.
Wong
Alice Yuen Kwan
AY
Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong SAR, People's Republic of China. alicewyk@netvigator.com
Tang
Lawrence
L
D000284:Administration, Oral; D000328:Adult; D003362:Cost-Benefit Analysis; D003613:Danazol / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D016527:Drug Costs; D004715:Endometriosis / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D004965:Estrogen Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008186:Luteolytic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D010166:Palliative Care; D010349:Patient Compliance; D010352:Patient Dropouts; D011182:Postoperative Care; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*
D004965:Estrogen Antagonists; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D003613:Danazol