Exploratory study of pre‐surgical medications with dienogest or leuprorelin in laparoscopic cystectomy of endometrial cysts

Takenaka, Motoki; Yano, Ryuichiro; Hiraku, Yuka; Shibata, Mayuko; Hatano, Kayoko; Yamamoto, Seishi; Sato, Kazuki; Yamamoto, Kazushige; Morishige, Kenichiro

doi:10.1111/jog.12701

Cited by 16 publications

(3 citation statements)

References 14 publications

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“…12 Another study reported no change in AMH levels after medical treatment, however they recruited patients using Dienogest and leuprorelin without proper discrimination of individual treatment effect. 25 Increased AMH levels after medical treatment might be explained by the decrease in inflammatory markers and toxic substances as the size of endometrioma decreases. 26 There is no proper information about the effect of medical treatment of endometrioma on ovarian reserve markers.…”

Section: Discussionmentioning

confidence: 99%

Ovarian reserve after dienogest therapy versus laparoscopic cystectomy for unilateral endometriomas: A randomized clinical trial

Atwa,

Ibrahim,

El Bassuony

et al. 2024

Journal of Endometriosis and Pelvic Pain Disorders

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Objective: To assess the effect of Dienogest versus surgical management of endometriomas on ovarian reserve. Methods: This randomized clinical trial was conducted at Suez Canal university hospital from November 1st, 2020, to July 31st, 2022. We recruited patients with endometriomas according to particular inclusion and exclusion criteria. The study population was allocated into two groups: group one received Dienogest, and group two had laparoscopic cystectomy. Eligible patients were subjected to history and examination to evaluate pelvic pain using the Biberoglu and Behrman score and the visual analogue scale. Ultrasound examination was done to diagnose ovarian endometrioma and its diameter. Ovarian reserve was evaluated by the antral follicle count and serum anti-mullerian hormone. After 3 months, patients were reevaluated regarding cyst diameter, antral follicle count, pain scores, and the anti-mullerian hormone. The primary outcome measure was to evaluate the ovarian reserve before and after intervention in both groups. Results: The antral follicle count and anti-mullerian hormone increased significantly after Dienogest therapy and decreased significantly after surgical excision ( p < 0.001). Only induration was significantly decreased in the medical treatment group ( p < 0.001). Both management options resulted in a noticeable reduction in the visual analogue scale scores in each group individually. Conclusion: Dienogest rescued ovarian reserve in women with endometriomas.

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Section: Discussionmentioning

confidence: 99%

Ovarian reserve after dienogest therapy versus laparoscopic cystectomy for unilateral endometriomas: A randomized clinical trial

Atwa,

Ibrahim,

El Bassuony

et al. 2024

Journal of Endometriosis and Pelvic Pain Disorders

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“…4 Prolonged use of GnRh is associated with hypo estrogenic side effects: Decreased libido, hot flushes, irregular menses, and decreased bone mineral density. 5 Dienogest is a 19-nor testosterone synthetic progestin suitable for effective endometrial lesion reduction, combined with moderate suppression of estrogen and reduction of inflammatory mechanism and angiogenesis. 6 Women with deep infiltrating endometriosis struggle with pain and reduced quality of life which induces high levels of anxiety, stress, and depression.…”

Section: Introductionmentioning

confidence: 99%

Dienogest treatment improves quality of life in women with endometriosis: A prospective cohort study

Arunadevi¹,

Minnalkodi²

2020

IJOGR

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One of the chronic disabling illness affecting approximately 10% of women in midst of their reproductive period is Endometriosis. The treatment goal of endometriosis is to activate decidualization within the hormonally dependent ectopic endometrium and is regularly given to alleviate pain symptoms and reduce its recurrence among women.The aim of the study was to evaluate the effectiveness of dienogest in reducing pain and its influence on (QOL) quality of life among women affected with endometriosis.A prospective observational cohort study was conducted at Karpaga Vinayaga Institute of Medical Sciences and Research Centre including fifty patients with endometriosis treated with dienogest two mg per day for three months. We assessed the pelvic pain symptoms by visual analogue scale and (QOL)quality of life was determined by physical and mental index before and after 3 months of use of dienogest.To perform statistical analysis, we used paired t test.Women were on average 33.18 ± 4.43 years. The mean ±SD of VAS of 7.72 (0.73) in women with endometriosis was progressively decreased to 4.34(0.66) after 3 months of treatment with dienogest. The physical index score values increased significantly from 31.94 to 42.77 (p<0.001). The mental index increased from 35.07 to 45.86 (p<0.001). Adverse effects include breast discomfort, headache, depression, acne, hot flushes and weight gain.The results suggest that among women with endometriosis, dienogest has a relatively favorable safety profile and is well accepted in bettering the quality of life (QOL).

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“…1 Therefore, long term use of GnRH-a is associated with hypo-estrogenic side effects: irregular menstrual period, hot flushes, vaginal burning, decreased libido and decreased bone mineral density. 4 Consequently, the use of GnRH-a is limited to a maximum of 6 months. 2 Dienogest (DNG) is a fourth-generation selective progestin that exhibit high selectivity for binding to progesterone receptors.…”

Section: Introductionmentioning

confidence: 99%

Dienogest versus gonadotropin-releasing hormone analogue for the clinical treatment of endometriosis: a systematic review and meta-analysis

Andrade¹,

Melo²,

Pereira³

2017

Int J Reprod Contracept Obstet Gynecol

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Endometriosis is a chronic inflammatory disease, defined by the presence of endometrial tissue outside the uterine cavity. It causes symptoms such as dysmenorrhea, chronic pelvic pain, dyspareunia, infertility, with great loss of quality of life for the patient. The objective of the study was to compare, through a meta-analysis, GnRH analogues, which are considered clinical first line treatment for endometriosis, versus dienogest, a selective oral progestin in the treatment of endometriosis. A systematic review was conducted to select the studies. In total, 31 articles were found. Four studies met criteria, the following variables were analyzed: pelvic pain, dyspareunia and induration of the Pouch of Douglas after treatment and it was evaluated the presence of side effects during treatment: hot flushes, headache and BMD loss. There was no difference between the dienogest group and GnRH analogue group when it was evaluated maintenance of lower abdominal pain, dyspareunia, induration of the Pouch of Douglas after treatment and hot flushes during treatment. Besides those results, the dienogest group had a lower incidence of headache and less BMD loss. The treatment of endometriosis continues to be a challenge, even with new treatment options such as new drugs (dienogest) and surgical procedures. This meta-analysis provides evidence of the absence of dienogest inferiority compared with GnRH analogues with less BMD loss and less headache incidence.

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Exploratory study of pre‐surgical medications with dienogest or leuprorelin in laparoscopic cystectomy of endometrial cysts

Abstract: There were no statistically significant differences between pre-surgical medication with dienogest and leuprorelin in post-surgical ovarian function. Both medications were effective in reducing endometrial cyst volume and VAS score.

Cited by 16 publications

References 14 publications

Ovarian reserve after dienogest therapy versus laparoscopic cystectomy for unilateral endometriomas: A randomized clinical trial

Ovarian reserve after dienogest therapy versus laparoscopic cystectomy for unilateral endometriomas: A randomized clinical trial

Dienogest treatment improves quality of life in women with endometriosis: A prospective cohort study

Dienogest versus gonadotropin-releasing hormone analogue for the clinical treatment of endometriosis: a systematic review and meta-analysis

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