Obstet Gynecol Sci.  2018 Jan;61(1):111-117. 10.5468/ogs.2018.61.1.111.

Clinical experience of long-term use of dienogest after surgery for ovarian endometrioma

• Chandra A
• Rho AM
• Jeong K
• Yu T
• Jeon JH
• Park SY
• Lee SR
• Moon HS
• Chung HW

• KMID: 2420159
• DOI: http://doi.org/10.5468/ogs.2018.61.1.111

Abstract

OBJECTIVE
Endometriosis is a common and recurring gynecologic disease which have afflicting females of reproductive age. We investigated the efficacy of long-term, post-operative use of dienogest for ovarian endometrioma.
METHODS
We studied 203 patients who had undergone laparoscopic or robotic surgery for ovarian endometrioma, and were administrated dienogest 2 mg/day beginning in July of 2013, and continuing. We evaluated side effects of dienogest and ultrasonography was performed every 6 months to detect potential recurrence of endometrioma (2 cm) in these post-surgical patients.
RESULTS
The follow-up observation periods were 30.2±20.9 months from surgery. The mean age was 34.1±7.2 years old. The mean diameter of pre-operative endometrioma was 5.6±3.0 cm2. One hundred eighty-two (89.7%) women received dienogest continuously for 12.0±7.1 months. Of the subjects, 21 (10.3%) patients discontinued dienogest at 2.4±1.0 months. The most common side effect when dienogest was discontinued was abnormal uterine bleeding. The occurrence rate of vaginal bleeding was 15.8%, a number which did not differ significantly in patients with/without post-operative gonadotropin releasing hormone agonist administration. The other side effects were gastrointestinal trouble including constipation, acne, headache, depression, hot flush, weight gain, and edema. However, no serious adverse events or side effects were documented and recurrent endometriomas were diagnosed in 3 patients (1.5%).
CONCLUSION
The data indicates that dienogest was both tolerable and safe for long-term use as prophylaxis in an effort to obviate the recurrence of ovarian endometrioma post-operatively, as well as potential need for surgical re-intervention.

Keyword

Dienogest; Endometriosis; Recurrence

MeSH Terms

Acne Vulgaris
Constipation
Depression
Edema
Endometriosis*
Female
Follow-Up Studies
Genital Diseases, Female
Gonadotropin-Releasing Hormone
Headache
Humans
Recurrence
Ultrasonography
Uterine Hemorrhage
Weight Gain
Gonadotropin-Releasing Hormone

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