Long-term oral contraceptive pills and postoperative pain management after laparoscopic excision of ovarian endometrioma: a randomized controlled trial.
OBJECTIVE
To evaluate postoperative long-term cyclic and continuous administration of combined oral contraceptive (OC) pills in preventing endometriosis-related pain recurrence.


METHODS
Prospective, randomized, controlled trial.


METHODS
Tertiary care university hospital.


METHODS
Three hundred eleven women who underwent laparoscopic excision for symptomatic ovarian endometrioma.


METHODS
Patients were randomly divided into three groups: nonuser group receiving no therapy, and cyclic user group and continuous user group receiving low-dose, monophasic OC pills for 24 months in either cyclic or continuous administration.


METHODS
Presence and intensity of dysmenorrhea, dyspareunia, and chronic pelvic pain were assessed by a 10-point visual analogue scale (VAS) at 6, 12, 18, and 24 months postoperatively.


RESULTS
A significant reduction in recurrence rate and VAS scores for dysmenorrhea was evident in the continuous users versus the other groups at 6 months, and in cyclic users versus nonusers at 18 months postoperatively. No significant differences in recurrence rate and VAS scores for dyspareunia and chronic pelvic pain were demonstrated among the groups. The increase of VAS scores from 6-24 months during the study period for dysmenorrhea, dyspareunia, and chronic pelvic pain was significantly higher in nonusers than in the other groups.


CONCLUSIONS
Long-term postoperative use of OC pills can reduce the frequency and the severity of recurrent endometriosis-related dysmenorrhea.
Seracchioli
Renato
R
S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. seracchioli@aosp.bo.it
Mabrouk
Mohamed
M
Frascà
Clarissa
C
Manuzzi
Linda
L
Savelli
Luca
L
Venturoli
Stefano
S
D000328:Adult; D002908:Chronic Disease; D003276:Contraceptives, Oral / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D004412:Dysmenorrhea / Q000188:drug therapy / Q000517:prevention & control; D004414:Dyspareunia / Q000188:drug therapy / Q000517:prevention & control; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control*; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D003276:Contraceptives, Oral