[Using GnRH-agonists (Zoladex) in the treatment of genital endometriosis].
METHODS
The study is prospective and involves 112 patients suffering from pelvic endometriosis aging from 19-38 years. (28.6 average age). The disease was diagnosed via laparoscopy and the stage was determined using the revised AFS classification. Zoladex (Goserelin depot--3.6 mg) is being applied every 28 days for 6 months in the hypodermic tissue of the front abdomen wall. All patients are being examined monthly after every Zoladex application (for subjective complaints--dysmenorrheal, dyspareunea, pelvic pain; serum estradyol-E2; amenorrhea; side effects) and every 24 months (recuperation of the menstrual cycle, pregnancy).


RESULTS
In 88% of the patients amenohrea is obsereved in the first eight weeks of therapy. The menstrual cycle takes an avarege of 68 (31-139) after the last Zoladex application to reappear. At the end of the first month after the first application the serum level of estradyol E2 is lowered to a menopause level (from 750-800 to 120-130 Pmol/L) and it remains as low till the end of the treatment. Eight weeks after the completion of the therapy it goes back to its normal values. During the course of the first month of amenorrhea condition a 38% fall in the level of complaints (dysmenorrheal, dyspareunea, pelvic pain) is observed. After the 6th month 88% of the patients have no complaints. Side effects observed during the course of treatment include warm waves, sweating, vaginal dehydration (60-80%) which do not in any way disturb the patients to the point of quitting the therapy and do disappear with its end. The focus group contains 54 infertile patients with endometrioses willing to get pregnant. In 12 months after the completion of the treatment 16 of the patients become pregnant, followed by 12 more in the next one year.


CONCLUSIONS
Zoladex causes amenorrhea, which lasts till the end of the treatement. It causes a rapid drop of the serum consentration to a menopause level. Causes a strong and durable treatment of the symptoms of endometriosis. The side effects disappear with the end of the therapy. The treatment is easy to go through and there no cases of a quitting patient. The treatment has a curable effect over the endometriosys and in cases of infertility provides a possibility for pregnancy.
Nikolov
A
A
Tiufekchieva
E
E
Novachkov
V
V
Karag'ozov
I
I
D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced* / Q000503:physiopathology; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D017273:Goserelin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects*; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome
D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone