Postoperative administration of dienogest plus estradiol valerate versus levonorgestrel‐releasing intrauterine device for prevention of pain relapse and disease recurrence in endometriosis patients
Abstract
Aim: In recent years, both dienogest, a fourth‐generation progestin, and levonorgestrel‐releasing intrauterine device have been found to be effective in terms of endometriosis‐related pelvic pain improvement. No data, however, are available about their efficacy in terms of postoperative recurrence prevention in women recently submitted to surgery for endometriosis at every stage. Our objective was to compare two postoperative medical approaches for pain control and reduction of recurrences in patients undergoing surgery for endometriosis. Material and Methods: Ninety‐two patients undergoing surgery for endometriosis and subsequent treatment by estradiol valerate + dienogest (EP) (group A) or levonorgestrel‐releasing uterine device (LNG‐IUD) (Group B) between J anuary 2009 and J une 2010 were retrospectively analyzed. The primary endpoints were pain relapse and disease recurrence rate at 12 and 24 months. The secondary endpoint was patient satisfaction with the therapy at 24 months. Results: Forty‐eight patients in Group A and 44 in Group B were examined. At 12 and 24 months a statistically greater reduction both in Ca125 levels and VAS score was seen in women treated with EP compared to LNG‐IUD. The recurrence rate at 12 and 24 months follow‐up was slightly lower, but not at a significant level, in Group A than in Group B. Finally, satisfaction with treatment at 24 months was significantly higher in Group B. Conclusion: EP administration is significantly more effective than LNG‐IUD in reducing pelvic pain and more effective in reducing recurrence rate but not at a significant level. LNG‐IUD, however, has significantly higher patient satisfaction.
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Two retrospective studies found that postoperative LNG-IUS use seems comparable to COC in preventing endometrioma recurrence.
“Two retrospective studies [88,89] compared the efficacy of postoperative use LNG-IUS with COC for preventing endometrioma recurrence. In both cases, postoperative LNG-IUS use seems comparable to that of COC in preventing endometrioma recurrence.”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [88]
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- Authors
- Morelli, M., Sacchinelli, A., Venturella, R., Mocciaro, R., & Zullo, F.
- Affiliations
- Magna Graecia University (IT)
- Corresponding author
- Venturella, Roberta
- Venue
- Journal of Obstetrics and Gynaecology Research
- Publisher
- Wiley
- Published
- 2013-04-03
- Volume
- 39
- Issue
- 5
- Pages
- 985-990
- ISSN
- 1341-8076 (ISSN-L)
- 1447-0756
- OpenAlex
- W1710395003
- Semantic Scholar
- a55f7fe6655ef8e9d331f825cdec3fafcb33d537
- Cited by
- 52
- References
- 25
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 6 · 2020: 4 · 2019: 1 · 2018: 9 · 2017: 9 · 2016: 5 · 2015: 2 · 2014: 3 · 2013: 2
- FWCI
- 4.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of obstetrics and gynaecology research (publishedVersion)
- PubMed (publishedVersion)
- Archive of Doctoral Theses and Digital Collections (University of Calabria) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- endometriosis, dienogest, estradiol valerate, levonorgestrel-releasing intrauterine system, postoperative recurrence prevention, pelvic pain, endometriosis surgery, CA125, patient satisfaction, progestin therapy
- MeSH terms
- Adult, Combined Modality Therapy, Contraceptive Agents, Female, Drug Combinations, Endometriosis, Estradiol, Estrogens, Female, Follow-Up Studies, Humans, Intrauterine Devices, Medicated, Nandrolone, Postoperative Care, Receptors, Progesterone, Retrospective Studies, Levonorgestrel, Patient Satisfaction, Pelvic Pain, Secondary Prevention
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