1355 To Evaluate the Difference of the Efficacy of Usual Cyclic Low-Dose Monophasic Oral Contraceptive (OC) Versus Dienogest (DNG) Hormonal Therapy in the Recurrence of after Laparoscopic Excision of Ovarian Endometrioma

Abstract

Study Objective To evaluate the efficacy of usual cyclic low-dose monophasic oral contraceptive (OC) use versus dienogest (DNG) in the recurrence of endometrioma after surgery. Design Retrospectively reviewed. Setting 155 patients aged from 20 years old to 40 years old who underwent laparoscopic excision of ovarian endometriomas in the department of obstetrics and gynecology of Toho University sakura medical center between April 2009 and March 2015. Patients or Participants All patients were reproductive-aged women with regular menstruation and did not want to get pregnant promptly after surgery. Interventions In the presence of endometrioma, cystectomy was performed and resection of all visible endometriosis was performed with the use of standard laparoscopic equipment. Following surgery, patients chose to receive OC, DNG for 1 year or no medication. The patients were evaluated at 3-month intervals during the following years after surgery. The recurrence rate was observed at 36 months postoperatively. Measurements and Main Results A significant reduction in recurrence rate was evident in OC and DNG users versus nonusers at 36 months postoperatively. Postoperative DNG use dramatically decreased the risk of ovarian endometrioma recurrence. Overall, there were no differences between the no recurrence and recurrence groups in terms of age, BMI, or tumor size. It was also noted that most of the OC user recurrent endometriomas were bilateral, multilocular, associated with DIE and stage IV by rASRM classification. Conclusion A significant reduction in recurrence rate was evident in OC and DNG users postoperative hormonal therapy. The stage and severity of endometriosis was significant higher in OC user recurrence group. Therefore, DNG therapy is the best option for prevention of recurrence.