Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Tommaso Campanella Cancer Center of Germaneto, Magna Graecia University, Catanzaro, Italy.
Gynecol Endocrinol. 2013 Apr;29(4):305-8. doi: 10.3109/09513590.2012.743017. Epub 2013 Jan 17.
The aim of this study was to evaluate the improvement in catamenial chronic pelvic pain (CPP) after Gonadotropin Releasing Hormone analogue (GnRH-a) administration in women affected by adenomyosis or endometriosis. We retrospectively analysed clinical data of 63 premenopausal women with clinical suspect of adenomyosis (15 women, Group A) or endometriosis (48 women, Group B), which received GnRH-a in order to reduce CPP intensity during the time on surgery waiting list. Main outcome measures were variation of CPP intensity, numbers of days requiring analgesics and lost work productivity before and three months after GnRH-a administration. Compared to baseline, a significant decrease in CPP intensity (p < 0.05) was observed in both groups, even if this reduction was significantly higher in Group A than in Group B (p < 0.001). In both groups, moreover, a significant reduction in number of days requiring analgesics (p < 0.05) and lost work productivity (p < 0.05) was detected. In conclusion, GnRH-a administration in women with clinical suspect of adenomyosis induces a greater reduction in CPP when compared to women with endometriosis, thus representing a potential ex adiuvantibus criteria, helping TV-US in the clinical diagnosis of adenomyosis.
本研究旨在评估促性腺激素释放激素类似物(GnRH-a)治疗子宫腺肌病或子宫内膜异位症患者月经性慢性盆腔痛(CPP)的改善情况。我们回顾性分析了 63 例有临床疑似子宫腺肌病(15 例,A 组)或子宫内膜异位症(48 例,B 组)的绝经前妇女的临床资料,这些患者接受 GnRH-a 治疗以降低手术等待期间 CPP 强度。主要观察指标为 CPP 强度、镇痛药使用天数和 GnRH-a 治疗前 3 个月的工作生产力损失的变化。与基线相比,两组 CPP 强度均显著降低(p<0.05),但 A 组的降低幅度明显高于 B 组(p<0.001)。此外,两组镇痛药使用天数(p<0.05)和工作生产力损失(p<0.05)均显著减少。总之,与子宫内膜异位症患者相比,GnRH-a 治疗有临床疑似子宫腺肌病的妇女 CPP 降低幅度更大,因此可能成为 TV-US 临床诊断子宫腺肌病的辅助标准。