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.
Cobellis
Luigi
L
Department of Gynaecology, Obstetrics and Reproduction, Second University of Naples, Naples, Italy.
Razzi
Sandro
S
De Simone
Simona
S
Sartini
Annalisa
A
Fava
Antonio
A
Danero
Secondo
S
Gioffrè
Walter
W
Mazzini
Massimo
M
Petraglia
Felice
F
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