Effects Of Different Durations Of GnRH-a Treatment After Laparoscopic Conservative Surgery For Endometriosis

ObjectiveThis study was aimed to compare the efficacy and adverse effects of different durations of gonadotropin-releasing hormone agonist(GnRH-a)treatment after laparoscopic conservative surgery for endometriosis(EMT).MethodsEighty women treated with GnRH-a after EMS surgery in the department of gynecology of the Second Affiliated Hospital of Soochow University between October2014 and June 2016 were recruited to the study.The subjects were divided into two groups as follows: group A(n = 50)received 3 months and group B(n = 30)received 6 months of GnRH-a treatment every 28 days after laparoscopic conservative surgery.Serum sex hormonal levels including 17b-estradiol(E2),follicle-stimulating hormone(FSH),and luteinizing hormone(LH)were measured during the follow-up.Remission of dysmenorrhea after the therapy was also followed up.Menopausal symptoms were evaluated by using the Kupperman index.Bone turnover markers(BTMs)including N-terminal propeptide of type I procollagen(PINP)and C-terminal telopeptide of type I collagen(β-CTx)were used to assess bone metabolism levels.ResultsAfter the therapy,the E2 levels were(8.56±5.24)and(11.99±5.32)pg/mL in groups A and B,respectively,no significant difference was observed between the two groups(p=0.165).The kupperman index was(10.52?3.97)in group A and(11.57?4.76)in group B,which did not show significant difference(p=0.29).However,the incidence of hot flashes/sweating and insomnia were 70.0%(35/50)and 54.0%(27/50)in group A,which were significantly lower than 93.3%(28/30)and 80.0%(24/30)in group B(p<0.05).The remission rate of dysmenorrhea were 62.2% and 88.9% in groups A and B,respectively,showing significant statistical difference between the two groups(p=0.03).The levels of the bone turnover markers after the treament in group A were lower than those in group B,showing statistical difference(p<0.05).ConclusionsThe levels of bone turnover markers in 3-months treatment of GnRH-a showed less increase than in the 6-months group,and 3-months therapy showed less menopausal symptoms,thus increasing patients’ quality of life(QOL).