The treatment with a COX-2 specific inhibitor is effective in the management of pain related to endometriosis.
OBJECTIVE
To evaluate the efficacy and safety of a cyclooxygenase (COX)-2 specific inhibitors versus placebo in the treatment of endometriosis-associated pelvic pain.


METHODS
A group of women (n = 28) with pelvic pain after conservative surgery for symptomatic endometriosis (Stage I and II) were enrolled at the Department of Pediatric, Obstetrics and Reproductive Medicine of University of Siena. A treatment with a COX-2 specific inhibitors (rofecoxib, 25mg per day) (n = 16) or placebo (n = 12) was given for 6 months. Pelvic pain quantification with a clinical evaluation, including Visual Analogue Scale (VAS) for pain, was performed before and up to 6 months after treatment.


RESULTS
A significant improvement of both pelvic pain and dyspareunia was observed after a 6 months persisting since the end of the treatment (P < 0.0001). The efficacy of rofecoxib was higher than placebo and no recurrence occurred, while in the placebo-treatment a 16% (2/12) occurred. No significant side effects have been found with the use of rofecoxib.


CONCLUSIONS
The use of COX-2 specific inhibitors was effective, safe and low cost therapy in the management of pelvic pain associated to endometriosis and might be also proposed in early stage of endometriosis.
Department of Gynaecology, Obstetrics and Reproduction, Second University of Naples, Naples, Italy.
Luigi
L
Cobellis
Sandro
S
Razzi
Simona
S
De Simone
Annalisa
A
Sartini
Antonio
A
Fava
Secondo
S
Danero
Walter
W
Gioffrè
Massimo
M
Mazzini
Felice
F
Petraglia
D000328:Adult; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D004715:Endometriosis / Q000150:complications*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007783:Lactones / Q000627:therapeutic use*; D010535:Laparoscopy / Q000009:adverse effects; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology; D013450:Sulfones; D016896:Treatment Outcome
D016861:Cyclooxygenase Inhibitors; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib