TITLE:
Efficacy Analysis of an Experience on Development of the Combination Therapy Protocol for Endometriosis Management
AUTHORS:
Abo Taleb Saremi, Ameneh Lahooti Eshkevari, Katayoun Esmaili Pour, Arash Pooladi
KEYWORDS:
Endometriosis, Combinational Therapy, Management, Protocol Development, Efficacy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.1,
December
23,
2016
ABSTRACT: Purpose: Endometriosis can be managed effectively by medication, surgery, or a combination of both. Numerous studies have been conducted on surgical and medication treatment options, but their results are still under discussion. Therefore, we performed a study to develop a combinational treatment for various stages of endometriosis. Methods: Over a 3-year period, 218 documented endometriosis patients were classified in 4 stages. After first laparoscopy (with electrocoagulation and adhesion removal for stages I to III), the patients were treated with GnRH analogs (Gonadotropin Releasing Hormone Agonist-375 mg of Decapeptyl) for 3, 6 & 6 months, respectively. The second and third laparoscopy procedures were performed after 3 and 6 months, with add-back therapy. The treatment was evaluated by direct observation based on laparoscopic view and the pain relief was measured by the VAS (Visual Analogue Scale) after the first step of medication for patients of stages I-III. Results: After 3 months, 70/76 patients (91.9%) with stage-I endometriosis showed complete recovery (six cases after 6 months) while 65/72 and 32/43 cases with stage-II and -III (90.3 and 74.4%), respectively, showed complete recovery after 6 months of treatment. The remaining patients had GnRH treatment for another 3 months, and all showed a complete recovery after 9 months. Furthermore, 12 of the patients with stage-IV symptoms were candidates for laparoscopy or laparotomy, and their treatment response rate was 55.6%. The pain relief was significant after the combinational treatment in patients with stages I-III (P = 0.0001). Conclusion: Our study showed efficacy of the developed protocol for the endometriosis management.