A Randomized Control Trial of Combined Surgical and Hormonal Therapy of Endometriosis
Madhu Bala, Humaira Tahir, Paras Soomro, Safia Maqsood, Nadia Nawaz, Parigul Baloch
1020
ABSTRACT
Aim:
To evaluate the three therapy
strategies including surgical therapy, hormonal therapy, and combined treatment
for the management of endometriosis
Study
design: A multicentric randomized control
trial
Place
and Duration: This study was conducted in 6 different hospitals of Pakistan, Muhammad Medical and Dental College Ratanabad
Mirpurkhas, Social Security Landhi Hospital Karachi, Sindh Government CDF
Hospital , Bilawal Medical College for Boys Jamshoro, Ghulam Muhammad Mahar
Medical College Sukkur, Bahria
International Hospital Karachi, Sandeman Provincial Hospital Quetta
Pakistan Pakistan from June 2020 to June
2021.
Methodology:
The study included 360 participants
with genital endometriosis. The age of the patients ranged from 18 years to 45
years. All the patients did not have any previous surgical intervention. The
patients were randomly treated with one of the three treatments. A laparoscopic
evaluation was done after three months of hormonal and combined therapy.
Re-evaluation of surgically treated patients was done after 5 to 6 months.
Stage of endometriosis, recurrence of symptoms, and the rate of pregnancy were
noted in the re-evaluation phase of the study.
Results:
The overall cure rate of all types
of endometriosis was 56.11% after every regimen of treatment. The cure rate
after treatment from combined therapy was 60%. Those treated exclusively by
hormone therapy showed a cure rate of 54.17%. A total of 54.17% of patients
were cured exclusively by surgical treatment. The rate of recurrence was lowest
in the patients given combined therapy. Dyspareunia and dysmenorrhea were
significantly reduced. The overall rate of pregnancy was 53% to 64%. The rate
of pregnancy was not different among all the groups.
Conclusion:
After giving hormonal therapy,
surgical treatment, and combined treatment, it has been noticed that recurrence
was lowest in the combined medical and surgical treatment group. The rate of
pregnancy had also got better after all the means of treatment. The highest
rate of cure was achieved by combined therapy.
Keywords: Endometriosis, laparoscopy, hormone therapy, combined
treatment, infertility, recurrence
ABSTRACT
Aim:
To evaluate the three therapy
strategies including surgical therapy, hormonal therapy, and combined treatment
for the management of endometriosis
Study
design: A multicentric randomized control
trial
Place
and Duration: This study was conducted in 6 different hospitals of Pakistan, Muhammad Medical and Dental College Ratanabad
Mirpurkhas, Social Security Landhi Hospital Karachi, Sindh Government CDF
Hospital , Bilawal Medical College for Boys Jamshoro, Ghulam Muhammad Mahar
Medical College Sukkur, Bahria
International Hospital Karachi, Sandeman Provincial Hospital Quetta
Pakistan Pakistan from June 2020 to June
2021.
Methodology:
The study included 360 participants
with genital endometriosis. The age of the patients ranged from 18 years to 45
years. All the patients did not have any previous surgical intervention. The
patients were randomly treated with one of the three treatments. A laparoscopic
evaluation was done after three months of hormonal and combined therapy.
Re-evaluation of surgically treated patients was done after 5 to 6 months.
Stage of endometriosis, recurrence of symptoms, and the rate of pregnancy were
noted in the re-evaluation phase of the study.
Results:
The overall cure rate of all types
of endometriosis was 56.11% after every regimen of treatment. The cure rate
after treatment from combined therapy was 60%. Those treated exclusively by
hormone therapy showed a cure rate of 54.17%. A total of 54.17% of patients
were cured exclusively by surgical treatment. The rate of recurrence was lowest
in the patients given combined therapy. Dyspareunia and dysmenorrhea were
significantly reduced. The overall rate of pregnancy was 53% to 64%. The rate
of pregnancy was not different among all the groups.
Conclusion:
After giving hormonal therapy,
surgical treatment, and combined treatment, it has been noticed that recurrence
was lowest in the combined medical and surgical treatment group. The rate of
pregnancy had also got better after all the means of treatment. The highest
rate of cure was achieved by combined therapy.
Keywords: Endometriosis, laparoscopy, hormone therapy, combined
treatment, infertility, recurrence