title: Exploratory study of pre-surgical medications with dienogest or leuprorelin in laparoscopic cystectomy of endometrial cysts.
abstract: OBJECTIVE
  The aim of this study was to compare the effects of pre-surgical medication with dienogest or leuprorelin on post-surgical ovarian function.
  
  
  METHODS
  We conducted an exploratory study in two centers in Japan that comprised 30 patients with ovarian endometrial cysts for whom surgical excision was planned. Patients were enrolled and divided into pre-surgical medication groups with dienogest or leuprorelin for 12 weeks. Thereafter, patients were treated by laparoscopic cystectomy. The primary outcome was ovarian function post-surgery, as assessed by serum anti-Müllerian hormone (AMH) level, antral follicle count (AFC) and resumption of menses. Secondary outcome was the effect of pre-surgical medication, as assessed by the size of endometrial cysts and visual analog scale (VAS) score. Serum AMH, AFC, size of endometrial cysts, and VAS scores were measured at baseline (before medication), after medication (1 day before surgery), and at 4 and 12 weeks post-surgery.
  
  
  RESULTS
  Serum AMH levels did not change after pre-surgical medication with either dienogest or leuprorelin. Although AMH decreased after surgery, it recovered by 12 weeks post-surgery in both groups with no statistically significant difference. Mean AFC did not change after surgery in either group. Menses returned by 12 weeks post-surgery in all patients except for those who were pregnant. The rate of reduction of endometrial cyst volume did not differ between the groups. Both dienogest and leuprorelin were associated with substantial reductions in VAS scores.
  
  
  CONCLUSIONS
  There were no statistically significant differences between pre-surgical medication with dienogest and leuprorelin in post-surgical ovarian function. Both medications were effective in reducing endometrial cyst volume and VAS score.
authors.affiliation: Department of Obstetrics and Gynecology, Gifu University School of Medicine.
authors.forename: Motoki
authors.initials: M
authors.lastname: Takenaka
authors.affiliation: Department of Obstetrics and Gynecology, Gifu University School of Medicine.
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Yano
authors.affiliation: Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Hiraku
authors.affiliation: Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Shibata
authors.affiliation: Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Hatano
authors.affiliation: Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: Shiori
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Obstetrics and Gynecology, Gifu University School of Medicine.
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Morishige
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D004715:Endometriosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016729:Leuprolide / Q000627:therapeutic use*; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010048:Ovarian Cysts / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D010053:Ovary / Q000473:pathology / Q000503:physiopathology; D064232:Visual Analog Scale
chemical_list: C023635:dienogest; D009277:Nandrolone; D054304:Anti-Mullerian Hormone; D016729:Leuprolide
keywords: endometrial cyst; laparoscopic cystectomy; ovarian function; pre-surgical medication