Research question

How effective is medical hormonal treatment in preventing endometriosis recurrence and in improving women's clinical symptoms and quality of life?

Design

This observational cross-sectional study evaluated the effects of hormonal medical treatment (progestins, gonadotrophin-releasing hormone analogues or continuous oral contraceptives) on endometriosis recurrence, current clinical symptoms and quality of life in three groups of patients: Group A (n = 34), no hormonal treatment either before or after the first endometriosis surgery; Group B (n = 76), on hormonal treatment after the first endometriosis surgery; and Group C (n = 75), on hormonal treatment both before and after the first endometriosis surgery.

Results

Group C patients were characterized by a lower rate of endometriosis reoperation (P = 0.011) and a lower rate of dysmenorrhoea (P = 0.006). Women who experienced repetitive endometriosis surgery showed worse physical (P = 0.004) and mental (P = 0.012) status than those who received a single surgery, independent of the treatment.

Conclusion

Hormonal treatments represent a valid cornerstone of endometriosis management and may be useful as an alternative to surgery, but also before surgery, to plan better, and after surgery in order to reduce the risk of recurrence. Medical counselling is very helpful in choosing the correct and individualized endometriosis treatment. In fact, the gold standard for modern endometriosis management is the individualized approach and surgery should be considered, depending on the clinical situation and a patient's symptoms.

中文翻译：

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长期激素治疗可减少子宫内膜异位症复发的重复手术

研究问题

医学激素治疗在预防子宫内膜异位症复发和改善女性临床症状和生活质量方面的效果如何？

设计

这项观察性横断面研究评估了激素药物治疗（孕激素、促性腺激素释放激素类似物或连续口服避孕药）对三组患者的子宫内膜异位症复发、当前临床症状和生活质量的影响：A 组（n  = 34） , 第一次子宫内膜异位症手术前后均未接受激素治疗；B组（n  = 76），在第一次子宫内膜异位症手术后进行激素治疗；和 C 组（n  = 75），在第一次子宫内膜异位症手术前后进行激素治疗。

结果

C组患者的子宫内膜异位症再手术率较低（P  =0.011）和痛经率较低（P  =0.006）。经历过重复子宫内膜异位症手术的女性 比接受单次手术的女性表现出更差的身体（P  = 0.004）和精神（P = 0.012）状态，独立于治疗。

结论

激素治疗是子宫内膜异位症管理的有效基石，可作为手术的替代方案，也可用于手术前更好地计划和手术后降低复发风险。医疗咨询对于选择正确和个性化的子宫内膜异位症治疗非常有帮助。事实上，现代子宫内膜异位症治疗的金标准是个体化的方法，应该根据临床情况和患者的症状考虑手术。