title: Hormonal suppression treatment or dietary therapy versus placebo in the control of painful symptoms after conservative surgery for endometriosis stage III-IV. A randomized comparative trial.
abstract: OBJECTIVE
  To evaluate the effectiveness for the outcomes of endometriosis-related pain and quality of life of conservative surgery plus placebo compared with conservative surgery plus hormonal suppression treatment or dietary therapy.
  
  
  METHODS
  Randomized comparative trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Two hundred twenty-two consecutive women who underwent conservative pelvic surgery for symptomatic endometriosis stage III-IV (r-AFS).
  
  
  METHODS
  Six months of placebo (n = 110) versus GnRH-a (tryptorelin or leuprorelin, 3.75 mg every 28 days) (n = 39) or continuous estroprogestin (ethynilestradiol, 0.03 mg plus gestoden, 0.75 mg) (n = 38) versus dietary therapy (vitamins, minerals salts, lactic ferments, fish oil) (n = 35).
  
  
  METHODS
  Painful symptoms (visual analogue scale score) and quality-of-life endometriosis-related symptoms (SF-36 score) at 12 months' follow-up.
  
  
  RESULTS
  Patients treated with postoperative hormonal suppression therapy showed less visual analogue scale scores for dysmenorrhoea than patients of the other groups. Hormonal suppression therapy and dietary supplementation were equally effective in reducing nonmenstrual pelvic pain. Surgery plus placebo showed significative decrease in dyspareunia scores. Postoperative medical and dietary therapy allowed a better quality of life than placebo.
  
  
  CONCLUSIONS
  Postoperative hormonal suppression treatment or dietary therapy are more effective than surgery plus placebo to obtain relief of pain associated with endometriosis stage III-IV and improvement of quality of life.
authors: Endometriosis Center, Section of Gynecology & Obstetrics, Department of Surgery, Tor Vergata University Hospital, Rome, Italy. Francesco.Sesti@uniroma2.it
authors: Francesco
authors: F
authors: Sesti
authors: Adalgisa
authors: A
authors: Pietropolli
authors: Talia
authors: T
authors: Capozzolo
authors: Patrizia
authors: P
authors: Broccoli
authors: Silvia
authors: S
authors: Pierangeli
authors: Maria Rosa
authors: MR
authors: Bollea
authors: Emilio
authors: E
authors: Piccione
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D004338:Drug Combinations; D004412:Dysmenorrhea / Q000178:diet therapy / Q000188:drug therapy / Q000209:etiology; D004414:Dyspareunia / Q000178:diet therapy / Q000188:drug therapy; D004715:Endometriosis / Q000178:diet therapy / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D009652:Norpregnenes / Q000627:therapeutic use*; D034445:Ovulation Inhibition / Q000187:drug effects; D010149:Postoperative Pain / Q000178:diet therapy* / Q000188:drug therapy* / Q000209:etiology; D010919:Placebos
chemical_list: D003278:Contraceptives, Oral, Hormonal; D004338:Drug Combinations; D009652:Norpregnenes; D010919:Placebos; C494367:estroprogestin; D007987:Gonadotropin-Releasing Hormone; D004997:Ethinyl Estradiol; D016729:Leuprolide