A Study of Secondlook Laparoscopic Findings After 6 Months GnRH Agonist Therapy in Endometriosis

Chi, J S; Suh, Y S; Seo, J H; Park, H M; Hur, M

Abstract

Endometriosis is a disease defined as the presence of endometrial tissue outside the uterus. The goal of treatment is to eliminate the endometriotic lesion and to treat sequellae. But no treatment successfully prevent the endometriosis. Among the many medical and surgical methods, we have been applied laparoscopic operation followed by 6 months GnRH agonist therapy. To evaluate the above treatment, we performed the retrospecitve study. The subjects were of the patients confirmed as endometriosis and treated by laparoscopy followed by 6 months goserelin therapy, 107 cases operated second look laparoscopy from July, 1992 to July, 1996 at Chung Ang University Hospital. Laparoscopic operations included the resection or enucleation of endometrioma, ablation of endometrial spots, lysis of adhesion and so forth. Clinical improvement was assessed by comparison of pretreatment American Fertility Society AFS) endometriosis scores and CA 125 with posttreatment AFS scores and CA 125. Of the 107 patients who were performed second look laparoscopy after 6 months of goserelin therapy, 98 cases were improved. AFS scores were 28.7+/-16.3 initially and 15.4+/-13.9 at second look laparoscopy. CA 125 levels were 77.5+/-40.2 U/ml and 29.7+/-22.4 U/ml. AFS scores and CA 125 levels were decreased significantly (p<0.05). It can be concluded that initial laparoscopic operation and goserelin therapy is effective treatment for endometriosis.