[Outcome analysis of stage III - IV endometriosis after conservative surgery]

To analyze the recurrence and fertility outcome of stage III - IV endometriosis after conservative surgery.

A retrospective study was performed on 90 women with stage III - IV endometriosis who had been diagnosed by pathology after conservative surgery. They were divided into three groups: 16 without endocrine therapy (Group A), 52 treated with gestrinone (Group B), 22 treated with gonadotropin releasing hormone agonist (GnRHa) (Group C). The number of infertile patients in the three groups was 10, 15 and 10, respectively. The recurrent and pregnant outcomes were compared after a median follow-up of 48.5 months (2 - 7 years).

The recurrent rate of groups A, B, and C was 18.8% (3/16), 30.8% (16/52) and 13.6% (3/22), respectively (P = 0.247); the recurrent time in the three groups were Group A: 63.8 months, Group B: 63.3 months, and Group C: 47.6 months (P = 0.376). There were no significant differences in pregnant outcome among the three groups. The cumulative pregnant rates were 70.0% (7/10), 66.7% (10/15) and 60.0% (6/10), respectively (P = 0.890). There was also no difference in the first pregnant interval after surgery (P = 0.092) and 65.2% of the patients acquired pregnancy spontaneously in the first year after surgery.

Neither gestrinone nor GnRHa can prolong the recurrent time or reduce the recurrent rate after conservative surgery. Surgery can improve the fertility ability of stage III and IV endometriosis patients; however, the pregnant rate cannot be improved with endocrine therapy after conservative surgery.