leuprolide and Pain--Postoperative

To evaluate the effectiveness for the outcomes of endometriosis-related pain and quality of life of conservative surgery plus placebo compared with conservative surgery plus hormonal suppression treatment or dietary therapy.. Randomized comparative trial.. University hospital.. Two hundred twenty-two consecutive women who underwent conservative pelvic surgery for symptomatic endometriosis stage III-IV (r-AFS).. Six months of placebo (n = 110) versus GnRH-a (tryptorelin or leuprorelin, 3.75 mg every 28 days) (n = 39) or continuous estroprogestin (ethynilestradiol, 0.03 mg plus gestoden, 0.75 mg) (n = 38) versus dietary therapy (vitamins, minerals salts, lactic ferments, fish oil) (n = 35).. Painful symptoms (visual analogue scale score) and quality-of-life endometriosis-related symptoms (SF-36 score) at 12 months' follow-up.. Patients treated with postoperative hormonal suppression therapy showed less visual analogue scale scores for dysmenorrhoea than patients of the other groups. Hormonal suppression therapy and dietary supplementation were equally effective in reducing nonmenstrual pelvic pain. Surgery plus placebo showed significative decrease in dyspareunia scores. Postoperative medical and dietary therapy allowed a better quality of life than placebo.. Postoperative hormonal suppression treatment or dietary therapy are more effective than surgery plus placebo to obtain relief of pain associated with endometriosis stage III-IV and improvement of quality of life.

Topics: Adult; Combined Modality Therapy; Contraceptives, Oral, Hormonal; Drug Combinations; Dysmenorrhea; Dyspareunia; Endometriosis; Ethinyl Estradiol; Female; Follow-Up Studies; Gonadotropin-Releasing Hormone; Humans; Leuprolide; Norpregnenes; Ovulation Inhibition; Pain, Postoperative; Placebos

To evaluate the use of pre-operative leuprorelin acetate for reducing the morbidity from hysterectomy for nonfibroid menorrhagia.. A double-blind, randomised, placebo-controlled trial.. Gynaecology department in a large university teaching hospital.. Fifty-one women without uterine fibroids awaiting abdominal or vaginal hysterectomy for dysfunctional uterine bleeding.. Participants received leuprorelin acetate or placebo for eight weeks prior to hysterectomy.. Operative blood loss, operative difficulty, first day morphine use, speed of return to 'normal health'.. The study and control groups were similar as regards prognostic factors. Two women in the study group withdrew because of side-effects. Although a 34% reduction in uterine volume was seen in those treated with leuprorelin, there were no significant differences in operative blood loss (183 mL in the study group vs 285 mL in controls, P = 0.27), operation time (39 vs 49 min, P = 0.64) or operative difficulty (visual analogue scale 3.0 vs 4.0, P = 0.09). Furthermore, there was no difference between the groups in post-operative morbidity or rate of recovery.. Treating women with leuprorelin acetate for 8 weeks prior to surgery for nonfibroid menorrhagia has no significant operative or post-operative benefits.

Topics: Adult; Analgesics, Opioid; Blood Loss, Surgical; Double-Blind Method; Female; Fertility Agents, Female; Humans; Hysterectomy; Leiomyoma; Leuprolide; Menorrhagia; Morphine; Pain, Postoperative; Preoperative Care

Topics: Electrocoagulation; Female; Fertility Agents, Female; Gonadotropin-Releasing Hormone; Humans; Leiomyoma; Leuprolide; Pain Measurement; Pain, Postoperative; Preoperative Care; Reference Values; Uterine Neoplasms; Uterus