Yamanaka Akiyoshi, Hada Tomonori, Matsumoto Tsuyoshi, Kanno Kiyoshi, Shirane Akira, Yanai Shiori, Nakajima Saori, Ebisawa Keiko, Ota Yoshiaki, Andou Masaaki
Department of Obstetrics and Gynecology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu, Shiga 520-2192, Japan; Department of Gynecology, Kurashiki Medical Center, 250, Bakurocho, Kurashiki, Okayama 710-0824, Japan.
Department of Gynecology, Kurashiki Medical Center, 250, Bakurocho, Kurashiki, Okayama 710-0824, Japan.
Eur J Obstet Gynecol Reprod Biol. 2017 Sep;216:51-55. doi: 10.1016/j.ejogrb.2017.07.014. Epub 2017 Jul 11.
To evaluate the effect of dienogest (DNG) in preventing the occurrence of pain and endometriomas after laparoscopic resection of uterosacral ligaments (USLs) with deep infiltrating endometriosis (DIE).
This retrospective analysis included 126 patients who underwent laparoscopic resection of USLs with DIE followed by postoperative administration of DNG or no medication. Every 6 months postoperatively, patients answered questions and underwent ultrasound examination to identify pain and/or endometrioma.
There were three (5.0%) cases of endometrioma in 59 patients from the DNG group and 21 (31.3%) cases in 67 patients from the no medication group (P=0.0002). Pain returned to preoperative levels in eight (11.9%) cases in the no medication group. No recurrence of pain occurred in the DNG group (P=0.0061).
The administration of DNG after resection of USLs with DIE significantly reduces the occurrence rate of endometriosis-related pain and endometriomas.
评估地诺孕素（DNG）在预防深部浸润型子宫内膜异位症（DIE）患者腹腔镜子宫骶韧带（USL）切除术后疼痛及子宫内膜瘤发生中的作用。
本回顾性分析纳入了126例行腹腔镜USL切除合并DIE且术后接受DNG治疗或未用药的患者。术后每6个月，患者回答相关问题并接受超声检查以确定疼痛和/或子宫内膜瘤情况。
DNG组59例患者中有3例（5.0%）发生子宫内膜瘤，未用药组67例患者中有21例（31.3%）发生（P = 0.0002）。未用药组有8例（11.9%）患者疼痛恢复至术前水平。DNG组未出现疼痛复发情况（P = 0.0061）。
DIE患者行USL切除术后给予DNG可显著降低子宫内膜异位症相关疼痛及子宫内膜瘤的发生率。
