Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran.
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Int J Gynaecol Obstet. 2022 Jan;156(1):124-132. doi: 10.1002/ijgo.13677. Epub 2021 Apr 2.
To compare the effects of dienogest and a combined oral contraceptive pill (COCP) after laparoscopic surgery on pain and quality of life in women with severe endometriosis.
A randomized double-blind pilot study was conducted from March 2018 to March 2020 in women with severe endometriosis confirmed by laparoscopic surgery. A total of 108 patients who had undergone laparoscopic surgery received dienogest, COCP, or placebo daily for 6 months. Primary and secondary outcomes were compared between the three groups.
Treatment with dienogest or COCP was associated with improved self-reported pain after 6 months of treatment, as evidenced by significantly lower scores for pelvic pain and dyspareunia compared with placebo (P < 0.05). Significant differences in overall quality of life score were observed over 6 months in the dienogest, COCP, and placebo groups (mean difference 22.00, 23.45, and 6.45 points, respectively; P < 0.001). Post-hoc analysis revealed a significant difference in overall quality of life score between the placebo group and the dienogest (P < 0.001) and COCP groups (P = 0.004).
Postoperative administration of dienogest or COCP reduced endometriosis-associated pain and improved quality of life in women with severe endometriosis.
比较地诺孕素和复方口服避孕药（COCP）在腹腔镜手术后对重度子宫内膜异位症患者疼痛和生活质量的影响。
本随机双盲试点研究于 2018 年 3 月至 2020 年 3 月在腹腔镜手术确诊的重度子宫内膜异位症患者中进行。共有 108 例接受过腹腔镜手术的患者接受地诺孕素、COCP 或安慰剂，每日 1 次，疗程 6 个月。比较三组之间的主要和次要结局。
地诺孕素或 COCP 治疗与治疗 6 个月后自我报告的疼痛改善相关，与安慰剂相比，盆腔疼痛和性交困难评分显著降低（P < 0.05）。在 6 个月期间，地诺孕素、COCP 和安慰剂组的整体生活质量评分均有显著差异（平均差异分别为 22.00、23.45 和 6.45 分；P < 0.001）。事后分析显示，安慰剂组与地诺孕素组（P < 0.001）和 COCP 组（P = 0.004）之间的整体生活质量评分差异有统计学意义。
术后给予地诺孕素或 COCP 可减轻重度子宫内膜异位症患者与疾病相关的疼痛并改善生活质量。
