title: Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?
abstract: OBJECTIVE
  The primary aim of the study was to analyze the endometrioma recurrence rate in patients who underwent laparoscopic excision followed by postoperative long-term regimen of oral contraceptives (OCs).
  
  
  METHODS
  168 patients who underwent a conservative laparoscopic surgery for endometrioma, during the period between September 2009 and August 2010 in three university hospitals were studied. A long-term OCs therapy was offered to all women following surgery. Patients were randomly divided into three groups according to different progestins used (desogestrel, gestodene, dienogest). Women who refused a postoperative hormonal therapy served as control. Follow-up visits and transvaginal scan were planned at 1, 3, 6, 12, and 24 months after surgery. All patients who showed an ultrasound persistence of the endometrioma at 1 month follow-up were excluded from clinical analysis.
  
  
  RESULTS
  Of the 168 patients, 131 completed the 24 months follow-up. Endometrioma recurrence was found in 21 (12.5 %) of all patients, it was unilateral in 17 cases while bilateral in 4 cases. The rate of recurrent endometrioma was statistically significant in non-users compared to the long-term OCs treated patients.
  
  
  CONCLUSIONS
  The current data suggest the usefulness of long-term OCs regimen after conservative surgery for the prevention of ovarian endometrioma recurrence. As a statistical significant difference could not be observed between OCs groups, further study on the individual molecules is required in order to really understand the effect of each of them.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital ''Paolo Giaccone'', Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Cucinella
authors.forename: Roberta
authors.initials: R
authors.lastname: Granese
authors.forename: Gloria
authors.initials: G
authors.lastname: Calagna
authors.forename: Alessandro
authors.initials: A
authors.lastname: Svelato
authors.forename: Salvatore
authors.initials: S
authors.lastname: Saitta
authors.forename: Gabriele
authors.initials: G
authors.lastname: Tonni
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Franciscis
authors.forename: Nicola
authors.initials: N
authors.lastname: Colacurci
authors.forename: Antonino
authors.initials: A
authors.lastname: Perino
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D017135:Desogestrel / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004715:Endometriosis / Q000517:prevention & control* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009652:Norpregnenes / Q000627:therapeutic use*; D010049:Ovarian Diseases / Q000517:prevention & control* / Q000601:surgery; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral; D009652:Norpregnenes; C033273:Gestodene; C023635:dienogest; D009277:Nandrolone; D017135:Desogestrel