[Hormone replacement therapy in women with surgical treatment of endometriosis and adenomyosis: prospective and follow-up study. Part I]

Abstract

Objective: To determine whether the initiation of estrogen replacement therapy (ERT) in the postoperative period increases the incidence of symptom recurrence following laparoscopic hysterectomy (LH) and/without bilateral salpingo-oophorectomy (BSO) for the treatment of endometriosis and adenomyosis.

Design: Prospective partially randomized patient preference follow up trial (PRPPT).

Setting: Department of Gynaecology, Endoscopic Training Centre, Kladno Hospital.

Methods: Chart review of 286 consecutive patients who underwent LH and/or without BSO for endometriosis or adenomyosis between April 1994 and June 1999 and who subsequently received ERT. The methods of second phase of trial was prepared. The symptoms of recurrence in patients who started ERT after surgery and in those who did not start ERT (control group) will be compared and adjusted.

Results: Seventy-three percent had preoperative pelvic pain. One hundred thirty two women (46.2%) had only endometriosis. Of the cases of endometriosis, 35.4% was stage I and 64.4% was stage II.-IV. One hundred fifty four women had adenomyosis, 60 with endometriosis.

Conclusion: In the first phase of follow study the collection of clinical data was performed. Preliminary results from the PRPPT demonstrate that laparoscopic approach to surgery for endometriosis increased significantly the number of this disease.