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Abstract

Study ObjectiveTo determine which therapy is most efficient in reducing the pain in endometriosis we compared three different treatment in patients with endometriosis and pelvic pain: only surgical treatment, surgery and GnRH analogue plus add-back therapy, and only medical treatment, GnRH analogue plus add back therapy.DesignRandomized controlled study.SettingUniversity hospital.PatientsSixty-three women with endometriosis-related pain diagnosed by laparoscopy.InterventionTwenty women were treated only with laparoscopic surgery to remove endometriotic foci, 22 women were treated with laparoscopic surgery and GnRH analogue plus add-back therapy, 21 women were treated with GnRH analogue plus add back therapy without surgical treatment for endometriosis: patients were treated or/and followed up for 12 months.Measurements and Main ResultsPain evaluation by a visual analogue scale and quality of life using the SF36 questionnaire were recorded at six months and at the end of treatment in all three study groups. Both groups of patients treated with medical therapy, women treated with only GnRH analogue plus add-back treatment, and patients treated with surgery plus medical therapy, showed a statistical significant higher reduction of pelvic pain, than ones treated with only surgery: either at six months and 12 months of treatment there was statistical significant differences in pain levels among the groups (3.5+1.5, 3.7+1.8, 5.9+2.1 respectively: p<0.01; 2.7+1.0, 2.9+1.1, 6.8+2.9 respectively: p<0.01).ConclusionAdd-back therapy alone, without surgery, and the combined treatment of surgery plus add back therapy allowed a better treatment of women with endometriosis-associated pain, with a better control of pain symptoms, compared to surgery treatment alone without medical treatment. Study ObjectiveTo determine which therapy is most efficient in reducing the pain in endometriosis we compared three different treatment in patients with endometriosis and pelvic pain: only surgical treatment, surgery and GnRH analogue plus add-back therapy, and only medical treatment, GnRH analogue plus add back therapy. To determine which therapy is most efficient in reducing the pain in endometriosis we compared three different treatment in patients with endometriosis and pelvic pain: only surgical treatment, surgery and GnRH analogue plus add-back therapy, and only medical treatment, GnRH analogue plus add back therapy. DesignRandomized controlled study. Randomized controlled study. SettingUniversity hospital. University hospital. PatientsSixty-three women with endometriosis-related pain diagnosed by laparoscopy. Sixty-three women with endometriosis-related pain diagnosed by laparoscopy. InterventionTwenty women were treated only with laparoscopic surgery to remove endometriotic foci, 22 women were treated with laparoscopic surgery and GnRH analogue plus add-back therapy, 21 women were treated with GnRH analogue plus add back therapy without surgical treatment for endometriosis: patients were treated or/and followed up for 12 months. Twenty women were treated only with laparoscopic surgery to remove endometriotic foci, 22 women were treated with laparoscopic surgery and GnRH analogue plus add-back therapy, 21 women were treated with GnRH analogue plus add back therapy without surgical treatment for endometriosis: patients were treated or/and followed up for 12 months. Measurements and Main ResultsPain evaluation by a visual analogue scale and quality of life using the SF36 questionnaire were recorded at six months and at the end of treatment in all three study groups. Both groups of patients treated with medical therapy, women treated with only GnRH analogue plus add-back treatment, and patients treated with surgery plus medical therapy, showed a statistical significant higher reduction of pelvic pain, than ones treated with only surgery: either at six months and 12 months of treatment there was statistical significant differences in pain levels among the groups (3.5+1.5, 3.7+1.8, 5.9+2.1 respectively: p<0.01; 2.7+1.0, 2.9+1.1, 6.8+2.9 respectively: p<0.01). Pain evaluation by a visual analogue scale and quality of life using the SF36 questionnaire were recorded at six months and at the end of treatment in all three study groups. Both groups of patients treated with medical therapy, women treated with only GnRH analogue plus add-back treatment, and patients treated with surgery plus medical therapy, showed a statistical significant higher reduction of pelvic pain, than ones treated with only surgery: either at six months and 12 months of treatment there was statistical significant differences in pain levels among the groups (3.5+1.5, 3.7+1.8, 5.9+2.1 respectively: p<0.01; 2.7+1.0, 2.9+1.1, 6.8+2.9 respectively: p<0.01). ConclusionAdd-back therapy alone, without surgery, and the combined treatment of surgery plus add back therapy allowed a better treatment of women with endometriosis-associated pain, with a better control of pain symptoms, compared to surgery treatment alone without medical treatment. Add-back therapy alone, without surgery, and the combined treatment of surgery plus add back therapy allowed a better treatment of women with endometriosis-associated pain, with a better control of pain symptoms, compared to surgery treatment alone without medical treatment.