Effectiveness of medical therapy for preventing ovarian endometriosis recurrence after surgical treatment

Objective. To study the effectiveness of therapy with dienogest (Zafrilla) in the prevention of ovarian endometriosis recurrence after surgical treatment. Patients and methods. This prospective observational comparative study enrolled 104 patients aged 20 to 49 years with morphologically verified diagnosis of ovarian endometriosis. Patients were divided into groups. Group 1 (n = 82) received postoperative therapy with dienogest (Zafrilla) (2 mg once daily for 24 weeks); group 2 (n = 22) did not receive postoperative hormonal therapy. The duration of postoperative follow-up was 12 months. Results. The recurrence rate of ovarian endometriosis within 12 months was 1.22% (1 out of 82) in group 1 and 22.7% (5 out of 22) in group 2. Against the background of postoperative therapy with dienogest in group 1, there was a statistically significant decrease in the average pain intensity and its transformation from moderate to mild after 3 months of therapy (2.5-fold on average) and to mild or complete relief after 6 months (5-fold on average, compared to the values before therapy), according to pain assessment scales (NRS, VAS). Group 2 showed a statistically significant increase in the average pain intensity on all scales and no statistically significant change in serum concentrations of the examined markers (IL-17, IL-6, IL-10, TNF-α), while group 1 demonstrated a statistically significant decrease in serum concentrations of all the examined inflammatory markers and the CA-125 marker. Conclusion. Dienogest (Zafrilla) can be considered as the main therapeutic approach for the long-term prevention of ovarian endometriosis recurrence after surgical treatment. © 2022, Dynasty Publishing House. All rights reserved.