Authors: 0ya GÖKMEN, Mustafa UĞUR
Abstract: A multicenter trial was carried out to evaluate the safety and efficacy of long acting preparation of Triptorelin-3.75 mg. (Decapeptlyl-Ferring/Erkim-Sweden) for the treatment of endometriosis. A total of 110 patients from 13 institutions with stage ll or higher endometriosis scores were included in the study; 105 of them completed the therapy. Patients underwent a 6-month course of monthly intramuscular injections during which changes in endometriosis symptoms, in biochemical, hematological, hormonal parameters and bone metabolism were evaluated. During the initial laparoscopy peritoneal implants were untouched; whereas of the 46 endometriomas encountered, they were either untouched (n: 13) or a surgical procedure [drainage(n: 23) fulguration (n: 3) cystectomy (n: 7)] was performed. At the end of the treatment, a second-look laparoscopy was performed (n: 93) to determine the efficacy of treatment on endometriotic implants. Initially 64% of patients complained of pelvic pain which dropped to 32% at the end of the treatment. Total AFS score, implants score, and implants score excluding endometriomas dropped significanly (p<0.0001; p<0.001, respectively) whereas adhesion scores were unchanged (p<0.05). Untouched endometriomas showed a mean 70% reduction of original size; whereas of the drainage group, 11 (48%) resolved, 7 (30%) decreased in size, and 5 (22%) were unchanged. 0f the fulguration group. 1 (33%) resolved and 2 (66%) decreased in size. Cystectomy performed endometriomas were found te resolve in all cases. Side-effects of the treatment were mostly due to the hypo-estrogenic state. Hot flashes, night sweats and vaginal dryness where the most prominant complaints. There was no harmful effects observed according to hematological, and biochemical parameters and bone metoblism. ln conclusion, this multicenter trial provides further evidence of the safety and efficacy of Gn-Rh agonist Triptorelin in the treatment of endometriosis.
Keywords: Endometriosis, gonadotropin releasing hormone agonist, Triptorelin, ovarian endometrioma, laparoscopy.