[Conservative surgery combined with depot medroxyprogesterone acetate in treatment of moderate or severe endometriosis].
OBJECTIVE
To evaluate the efficiency and side-effects of depot medroxyprogesterone acetate in the treatment of moderate or severe endometriosis after conservative surgery.


METHODS
Ninety-four women with moderate or severe endometriosis after conservative surgery were divided into three groups: 34 cases in the group of depot medroxyprogesterone acetate (DMPA) received intramuscularly depot medroxyprogesterone acetate 150 mg every 28 - 30 days for 6 months; 30 cases in the group of gonadotropin releasing hormone agonists (GnRH-a) received hypodermically leuprorelin acetate 3.75 mg every 28 - 30 days for 6 months; 30 cases in the group of control did not receive any postoperative medical treatment. Patients' symptoms and signs including pelvic pain, pelvic tenderness, menstrual and weight changes were recorded before and after treatment. Liver and renal functions, sex hormone level were also examined at the same time.


RESULTS
Both DMPA and GnRH-a treatment achieved similar significant relief of pelvic symptoms and signs (88% and 93%) compared with the control group (chi(2) = 12.273, P < 0.01; chi(2) = 9.604, P < 0.01). The cumulative recurrence rates of DMPA and GnRH-a groups were 6% and 7%, significantly lower than that of the control group (chi(2) = 5.222, P < 0.05; chi(2) = 4.320, P < 0.05). There were no significant differences between DMPA and GnRH-a groups (chi(2) = 0.488, P > 0.05; chi(2) = 0.017, P > 0.05). Serum estradiol (E(2)) level was significantly reduced in both DMPA and GnRH-a groups, but serum E(2) was maintained at the level of early follicular phase in the group of DMPA (120 +/- 9) pmol/L and menopause phase level in the group of GnRH-a (62 +/- 9) pmol/L. The main side effects of DMPA were menstrual changes, weight gain and delay of ovulation.


CONCLUSIONS
Depot medroxyprogesterone acetate seems to be an effective, safe, and convenient treatment for endometriosis with low-cost, good compliance, and few side effects.
Zhou
Jie
J
Department of Obstetrics and Gynecology, Second Affiliated Hospital, Wenzhou Medical College, Wenzhou 325027, China.
Lei
Zhen-wu
ZW
Lü
Jie-qiang
JQ
Sun
Jing
J
Xu
Xiao-wen
XW
D000328:Adult; D003131:Combined Modality Therapy; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists*; D006801:Humans; D010535:Laparoscopy; D016729:Leuprolide / Q000008:administration & dosage* / Q000009:adverse effects; D007986:Luteinizing Hormone / Q000097:blood; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000209:etiology
D003692:Delayed-Action Preparations; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D017258:Medroxyprogesterone Acetate; D016729:Leuprolide