title: Gonadotrophin-releasing hormone analogue or dienogest plus estradiol valerate to prevent pain recurrence after laparoscopic surgery for endometriosis: a multi-center randomized trial.
abstract: OBJECTIVE
  To evaluate the efficacy of dienogest + estradiol valerate (E2V) and gonadotrophin-releasing hormone analogue (GnRH-a) in reducing recurrence of pain in patients with chronic pelvic pain due to laparoscopically diagnosed and treated endometriosis.
  
  
  METHODS
  Multi-center, prospective, randomized study.
  
  
  METHODS
  Three university departments of obstetrics and gynecology in Italy.
  
  
  METHODS
  Seventy-eight women who underwent laparoscopic surgery for endometriosis combined with chronic pelvic pain.
  
  
  METHODS
  Post-operative administration of dienogest + E2V for 9 months (group 1) or GnRH-a monthly for 6 months (group 2).
  
  
  METHODS
  A visual analogue scale was used to test intensity of pain before laparoscopic surgery at 3, 6 and 9 months of follow up. A questionnaire to investigate quality of life was administered before surgery and at 9 months of follow up.
  
  
  RESULTS
  The visual analogue scale score did not show any significant differences between the two groups (p = 0.417). The questionnaire showed an increase of scores for all women compared with pre-surgery values, demonstrating a marked improvement in quality of life and health-related satisfaction with both treatments. No significant differences were found between the groups. The rate of apparent endometriosis recurrence was 10.8% in group 1 and 13.7% in group 2 (p = 0.962).
  
  
  CONCLUSIONS
  Both therapies seemed equally efficacious in preventing endometriosis-related chronic pelvic pain recurrence in the first 9 months of follow-up.
authors.affiliation: Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences, University Hospital "G. Martino", Messina, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Granese
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Perino
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Calagna
authors.affiliation: Department of Clinical and Experimental Medicine Human Pathology, University Hospital "G. Martino", Messina, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Saitta
authors.affiliation: Department of Obstetrics and Gynecology, II University, Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Franciscis
authors.affiliation: Department of Obstetrics and Gynecology, II University, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Colacurci
authors.affiliation: Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences, University Hospital "G. Martino", Messina, Italy.
authors.forename: Onofrio
authors.initials: O
authors.lastname: Triolo
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Cucinella
mesh_terms: D000293:Adolescent; D000328:Adult; D004338:Drug Combinations; D004715:Endometriosis / Q000601:surgery*; D004958:Estradiol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D007558:Italy; D010535:Laparoscopy; D008875:Middle Aged; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D059408:Pain Management; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D011795:Surveys and Questionnaires
chemical_list: D004338:Drug Combinations; C454300:estradiol valerate-dienogest; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D009277:Nandrolone
keywords: Endometriosis; GnRH-analogue; chronic pelvic pain; dienogest; pain recurrence