Modification of endometrioma size during hormone therapy containing dienogest

Abstract

The aim of the present study was to evaluate whether hormone therapy containing dienogest is effective in reducing endometrioma size. A retrospective observational study was conducted on 116 women with endometrioma which was evaluated after 6 and 12 months of either no treatment (n = 46), or hormonal therapy containing dienogest (n = 70), without (DNG; n = 34) or with ethinylestradiol (DNG/EE; n = 36). Median (interquartile range) cyst diameter (23.0 mm (21.0 mm)) and volume (9941.2 mm³ (14240.1 mm³)) of untreated were similar to cyst diameter (25.0 mm (14.5 mm) and volume (7587.7 mm³ (13806.2 mm³)) of treated women. After 12 months, endometrioma volume did not vary in untreated women (-34.0 mm³ (55595.0 mm³); -0.77% (93.9%)) while it significantly decreased (-5400 mm³ (15378.7 mm³); -100.0% (27.7%); p<.0001) during hormone therapy. Volume decrease was linearly related to endometrioma volume ($y=318.8-0.756x;$ R² = 0.899, p<.0001). The effect tended to be greater during DNG alone than DNG/EE (-100.0% (0.0%) vs. -87.9% (47.7%); p<.0004). Cyst disappearance was observed in 4.4% of untreated cases and in 57.1% of cases on hormone therapy (p<.0001) (38.9% with DNG/EE and 76.5% with DNG; p<.03). The early diagnosis and treatment of endometrioma with dienogest-based hormone therapy may be effective in controlling cyst growth and in reducing the need for surgery.

摘要

本研究的目的是评估应用地诺孕素的激素治疗是否可以有效减少子宫内膜异位囊肿的大小。一项回顾性观察性研究对116例患有子宫内膜异位囊肿女性进行了评估, 分为未进行任何治疗组（n = 46）、应用地诺孕素激素治疗组（n = 70）, 包括单用地诺孕素（DNG；n=34）和联合炔雌醇（DNG/EE；n = 36）, 在6个月和12个月后进行评估。未治疗组中位（四分位间距）囊肿直径（23.0 mm（21.0 mm））和体积（9941.2 mm3（14240.1 mm³））与治疗组患者囊肿直径（25.0 mm（14.5 mm））和体积（7587.7 mm3（13806.2 mm³））相似。12个月后, 未治疗的女性子宫内膜异位囊肿体积无变化（-34.0 mm³（55595.0 mm³）; -0.77％（93.9％））, 而激素治疗组显著下降（-5400 mm³（15378.7 mm3）；-100.0％（27.7％）； p <.0001）。体积的减少与子宫内膜异位囊肿体积线性相关（y = 318.8-0.756x； R² = 0.899, p <.0001）。 单独应用DNG的效果往往比DNG / EE更好（-100.0％（0.0％）, -87.9％（47.7％）； p <.0004）。未治疗组病例的囊肿消失率为4.4％, 接受激素治疗组为57.1％（p <.0001）（DNG / EE组为38.9％, DNG组为76.5％； p <.03）。对于子宫内膜异位症患者的尽早诊断和应用地诺孕素的激素治疗在控制囊肿生长和减少其手术可能是有效的。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Endometriosis
• contraception
• dysmenorrhea
• ultrasound
• infertility

Disclosure statement

The authors Anjeza Xholly, Gabriele Filip, and Francesca Previtera have no conflict of interest. Angelo Cagnacci has received fees by MSD, Bayer Italia, Gedeon-Richter, TEVA, Exeltis for advisory boards or congress presentations.