News: Best postop treatment for stage III-IV endometriosis

Following conservative pelvic surgery, hormonal suppression or dietary therapy are better than placebo at reducing pain and improving quality of life in women with stage III-IV endometriosis, according to the results of a randomized comparative trial involving 222 women.

The women were treated with either gonadotropin–releasing hormone analogue (GnRH-a) (tryptorelin or leuprorelin, 3.75 mg every 28 days); continuous estroprogestin (ethylnilestradiol, 0.03 mg plus gestoden 0.75 mg); a combination of vitamins, mineral salts, lactic ferments, and fish oil; or placebo.

At 1 year, the women treated with hormonal suppression showed greater improvement in visual analogue scale scores for dysmenorrhea than patients in the other groups, although the women receiving placebo also showed significant decreases in dyspareunia scores. Hormonal suppression and dietary therapy were equally effective in reducing nonmenstrual pelvic pain.