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Postoperative medical treatment of chronic pelvic pain related to severe endometriosis: levonorgestrel-releasing intrauterine system versus gonadotropin-releasing hormone analogue
Open accessAbstract
Objective To compare efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS; Mirena) with depot GnRH analogue (GnRH-a; gosareline acetate; Zoladex) on endometriosis-related chronic pelvic pain (CPP) in patients with severe endometriosis during 12 months.Design Prospective, randomized, controlled study.Setting The reproductive endocrinology unit of a tertiary, research and education hospital.Patient(s) Forty women with severe endometriosis (revised The American Fertility Society [AFS] classification >40) and endometriosis-related CPP and control groups were enrolled in the study.Intervention(s) The patients were treated with either LNG-IUS (n = 20) or GnRH-a (n = 20). The GnRH-a dose was repeated every 4 weeks for 24 weeks.Main outcome measure(s) Scores of CPP were evaluated using a visual analogue scale (VAS) and total endometriosis severity profile (TESP).Result(s) The TESP score decreased in the LNG-IUS group at first, third, and sixth month follow-up visits, whereas at the 12th month follow-up visit, the TESP scores were increased to values similar to pretreatment values. Although the VAS score had no significant alteration during the follow-up period in the LNG-IUS group, the GnRH-a group showed a significant decrease in the VAS score and TESP score at the end of 1 year. The LNG-IUS treatment showed a lower patient satisfaction.Conclusion(s) Both treatment modalities showed comparable effectiveness in the treatment of CPP-related endometriosis.
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“In fact, LNG-IUS use after surgery was associated with a significantly lower dysmenorrhea recurrence rate compared to with expectant management [231–233].”
From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [232]
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Metadata
- Authors
- Bayoglu Tekin, Y., Dilbaz, B., Altinbas, S. K., & Dilbaz, S.
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2011-02
- Volume
- 95
- Issue
- 2
- Pages
- 492-496
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2131027406
- Cited by
- 133
- References
- 29
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 6 · 2020: 7 · 2019: 6 · 2018: 13 · 2017: 18 · 2016: 8 · 2015: 14 · 2014: 12 · 2013: 15 · 2012: 5
- FWCI
- 8.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Keywords
- endometriosis, chronic pelvic pain, levonorgestrel-releasing intrauterine system, GnRH analogues, goserelin, endometriosis severity, patient satisfaction
- MeSH terms
- Adult, Chronic Disease, Delayed-Action Preparations, Endometriosis, Female, Fertility Agents, Female, Follow-Up Studies, Humans, Intrauterine Devices, Medicated, Gonadotropin-Releasing Hormone, Pain, Postoperative, Postoperative Pain, Gynecologic Surgical Procedures, Uterine Diseases, Treatment Outcome, Levonorgestrel, Goserelin, Pelvic Pain
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