EFFECTIVENESS OF COMBINED SURGICAL AND HORMONAL THERAPY IN TREATMENT OF ENDOMETRIOMAS

Area of Science:

• Gynecology
• Reproductive Medicine
• Surgical Oncology

Background:

• Endometrial cysts (endometriomas) are a severe form of endometriosis with high recurrence rates post-surgery.
• Effective management strategies are crucial to improve patient outcomes and quality of life.

Purpose of the Study:

• To evaluate the effectiveness of combined surgical and hormonal therapy for endometrioma.
• Key outcomes include recurrence rates, pregnancy rates, and changes in pain intensity.

Main Methods:

• A study involving 264 patients undergoing laparoscopic endometrioma enucleation.
• Patients were divided into four groups: dienogest, combined oral contraceptives (COC), dydrogesterone, and a control group without hormone therapy.

Main Results:

• Hormonal therapy significantly reduced endometrioma recurrence compared to surgery alone (1.6% vs. 18.2%).
• Dienogest and dydrogesterone groups showed significantly higher pregnancy rates (72.4% and 47.2%) versus control (34.8%).
• Dienogest and COC were most effective for severe pain, while all hormone therapies improved moderate pain significantly more than surgery alone.

Conclusions:

• Combined hormonal therapy after surgery substantially lowers endometrioma recurrence rates.
• Dienogest and COC demonstrate superior efficacy in managing severe pain associated with endometriomas.
• All tested hormonal treatments offer significant benefits over surgical intervention alone for pain relief and recurrence prevention.