Recurrent Endometrioma; Outcome of Medical Management with Dienogest

Aizzi, Fadia J

doi:10.21767/2248-9215.100039

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Aizzi reported a reduction of mean diameter of endometrioma from 5.45 cm baseline to 3.1 cm in twenty women treated with dienogest for 3 months. 23 By the end of the 6 th month's treatment, only 2 patients had residual cysts. Park et al 1 showed that by treatment with dienogest the size of endometrioma was significantly reduced at 12 months (30.9 versus 20.8 mm) and 18 months (20.5 versus 14.7mm).…”

Section: Discussionmentioning

confidence: 97%

Letrozole versus dienogest in endometrioma recurrent after surgery: a randomized controlled trial

Amir

Ishrat²,

Nasrin³

et al. 2022

Int J Reprod Contracept Obstet Gynecol

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Background: Letrozole is a third-generation aromatase inhibitor. As there is aberrant aromatase production by endometriotic stromal cells and the growth and regression of endometriosis is estrogen-dependent, the use of letrozole to reduce the size and symptoms of endometrioma especially in recurrent cases is a promising medical intervention. Dienogest is a fourth-generation progestin which is being used for the treatment of endometriosis due to its antiproliferative and antiangiogenic properties on endometrial tissue. The present study was conducted to compare the effects of letrozole and dienogest on endometrioma recurrent after surgery.Methods: This randomized controlled study was conducted on 38 women having recurrence of endometrioma after surgery. They were randomly assigned to receive either letrozole (2.5 mg daily) or dienogest (2 mg once daily) for 6 months. Size of the endometrioma was measured by transvaginal ultrasound and the pain (dysmenorrhoea) was measured on a visual analog scale (VAS) of 0-10, prior to treatment and after 3 and 6 months of treatment.Results: The mean size of endometrioma was reduced from a baseline of 6.06±2.40 cm to 5.23±1.37 cm and to 4.59±1.25 cm after 3 and 6 months of treatment with letrozole. While with dienogest the reduction was from a baseline of 6.67±1.31 cm to 4.83±1.50 cm and to 3.80±1.34 cm after 3 and 6 months of treatment. The difference between the two groups was not statistically significant but dienogest yielded better result in terms of effect size. Decrease in pain (dysmenorrhoea) was highly significant with both the drugs.Conclusions: In terms of reduction of the size of endometrioma, dienogest yields better results than letrozole. Both the drugs are highly effective in alleviating pain (dysmenorrhoea).

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Section: Discussionmentioning

confidence: 97%

Letrozole versus dienogest in endometrioma recurrent after surgery: a randomized controlled trial

Amir

Ishrat²,

Nasrin³

et al. 2022

Int J Reprod Contracept Obstet Gynecol

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Effects of Dienogest Therapy on Endometriosis-Related Dysmenorrhea, Dyspareunia, and Endometrioma Size

Gokmen¹,

Selçuki²,

Aydın³

et al. 2023

Cureus

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Introduction: Endometriosis is an estrogen-dependent chronic inflammatory disease that is defined by the presence of endometrial-like tissue outside of the uterus. The most common localization is the ovaries, and endometriosis in this location is then called an endometrioma. According to the European Society of Human Reproduction and Embryology (ESHRE) (2022) guidelines, the most commonly prescribed treatments for endometriosis include drugs that alter the hormonal milieu. Dienogest is a new generation of progestin used in the treatment of endometriosis. The aim of this study was to assess the effect of Dienogest treatment on endometrioma size and endometriosis-related pain symptoms over a six-month follow-up period.Methods: This prospective observational study was conducted at a tertiary clinic in Turkey between March 2020 and March 2021. Here, 64 patients aged 17-49 years with unilateral or bilateral endometriomas without any hormone-dependent cancers and any medical conditions contraindicating the onset of hormonal treatment, such as active venous thromboembolism, previous or current cardiovascular disease, diabetes with cardiovascular complications, current severe liver disease, and not being pregnant, were included. Endometrioma sizes were determined by transvaginal ultrasonography (TVUS). Dysmenorrhea and dyspareunia symptoms were evaluated using the visual analogue scale (VAS). Patients received Dienogest 2 mg/day continuously for six months. At the three-and six-month follow-ups, the patients were re-evaluated.Results: The mean endometrioma size decreased significantly from an initial measurement of 44.0 ± 13 mm to 39.5 ± 15 mm at three months and to 34.4 ± 18 mm at the six-month follow-up. The mean dysmenorrhea VAS scores before treatment, at the three-month follow-up, and at the six-month follow-up were 6.9 ± 2.6, 4.3 ± 2.8, and 3.8 ± 2.7, respectively. Dysmenorrhea VAS scores decreased significantly over the first three months (p<0.01). Similarly, the mean VAS score for dyspareunia decreased at three and six months compared with the pretreatment value (p<0.01). Conclusion:This study shows that dienogest treatment reduced the symptoms of dysmenorrhea and dyspareunia and the size of endometriomas. However, the main significant decrease in dysmenorrhea and dyspareunia symptoms was noted in the first three months, making it a good treatment option, especially in young patients with a fertility wish.

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Recurrent Endometrioma; Outcome of Medical Management with Dienogest

Abstract: Background: Management of recurrent endometrioma should balance between the risk of unexpected hidden malignancy and the damaging effect of second surgery to ovarian tissue. Dienogest is a fourth generation of progestin and has been used in endometriosis with effective and save reports.

Cited by 2 publications

References 16 publications

Letrozole versus dienogest in endometrioma recurrent after surgery: a randomized controlled trial

Letrozole versus dienogest in endometrioma recurrent after surgery: a randomized controlled trial

Effects of Dienogest Therapy on Endometriosis-Related Dysmenorrhea, Dyspareunia, and Endometrioma Size

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