Long-term cyclic and continuous oral contraceptive therapy and endometrioma recurrence: a randomized controlled trial
Received 9 July 2008; received in revised form 28 August 2008; accepted 14 September 2008. published online 29 October 2008.
Objective
To evaluate long-term cyclic and continuous administration of oral contraceptive pills (OCP) in preventing ovarian endometrioma recurrence after laparoscopic cystectomy.
Design
Prospective, randomized, controlled trial.
Setting
Tertiary care University Hospital.
Patient(s)
Two hundred thirty-nine women who underwent laparoscopic excision of ovarian endometriomas.
Intervention(s)
Patients were divided randomly into three groups: nonusers receiving no therapy and cyclic and continuous users receiving low-dose, monophasic OCP for 24 months in cyclic or continuous administration, respectively.
Main Outcome Measure(s)
Endometrioma recurrence, size of recurrent endometrioma, and growth rate during at least 2 years follow-up evaluated by transvaginal ultrasonography.
Result(s)
The crude recurrence rate within 24 months was significantly lower in cyclic (14.7%) and continuous users (8.2%) compared with nonusers (29%). The recurrence-free survival was significantly lower in nonusers compared with cyclic and continuous users. The mean recurrent endometrioma diameter at first observation was significantly lower in cyclic (2.17 ± 0.45 cm) and continuous users (1.71 ± 0.19 cm) compared with nonusers (2.73 ± 0.56 cm). The mean diameter increase every 6 months of follow-up was significantly reduced in cyclic users (0.31 ± 0.18 cm) and continuous users (0.25 ± 0.09 cm) versus nonusers (0.48 ± 0.3 cm). No significant differences between cyclic users and continuous users in terms of endometrioma recurrence were demonstrated.
Conclusion(s)
Long-term cyclic and continuous postoperative use of OCP can effectively reduce and delay endometrioma recurrence.
Minimally Invasive Gynaecological Surgery Unit, Reproductive Medicine Unit, S. Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
Reprint requests: Renato Seracchioli, M.D., Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40125 Bologna, Italy (FAX: 39-051-6363944).
R.S. has nothing to disclose. M.M. has nothing to disclose. C.F. has nothing to disclose. L.M. has nothing to disclose. G.M. has nothing to disclose. A.K. has nothing to disclose. S.V. has nothing to disclose.
ABSTRACT