Hormonal Substitution Treatment in Women Operatedon Account of Endometriosis and Adenomyosis:Prospective Follow-up Study -⁠ Part I

Overview

Objective:
To determine whether the initiation of estrogen replacement therapy (ERT) in thepostoperative period increases the incidence of symptom recurrence following laparoscopic hys-terectomy (LH) and/without bilateral salpingo-oophorectomy (BSO) for the treatment of endomet-riosis 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 forendometriosis or adenomyosis between April 1994 and June 1999 and who subsequently receivedERT. The methods of second phase of trial was prepared. The symptoms of recurrence in patientswho started ERT after surgery and in those who did not start ERT (control group) will becompared and adjusted.Results: Seventhy-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% wasstage 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. Preli-minary results from the PRPPT demonstrate that laparoscopic approach to surgery for endomet-riosis increased significantly the number of this disease.

Key words:
endometriosis, hormonal replacement therapy, laparoscopic hysterectomy