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Federación Mexicana de Ginecología y Obstetricia, A.C.
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2023, Number 05

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Ginecol Obstet Mex 2023; 91 (05)

Long-term management of pelvic pain with levonorgestrel in women with endometriosis who desire to postpone a future pregnancy and preserve their fertility. Case Series

Sánchez-Resendis Ó, Ávila-Morales J, Sánchez-Aguilar ÓE, Del Valle-Jiménez JH
Full text How to cite this article

Language: Spanish
References: 42
Page: 307-316
PDF size: 215.96 Kb.


Key words:

aGnRH, Endometriosis, Gosereline, Levonorgestrel, Pelvic pain, Tibolone.

ABSTRACT

Objective: To assess the long-term treatment of pelvic pain with levonorgestrel in women with endometriosis who wish to postpone pregnancy and preserve their fertility.
Materials and Methods: Ambispective study, with drug intervention, longitudinal and descriptive case series. Study parameters: measurement of pain intensity at 12, 24 and 36 months after placement of a single goserelin implant (Zoladex 10.6 mg, AstraZeneca AB, Gärtunavägen). At the return of menstruation, an intrauterine device containing levonorgestrel (Mirena Bayer AG, Leverkusen) was inserted. The intensity of pelvic pain was measured with the Numerical Pain Scale (NPS).
Results: Fourteen patients were studied of whom five reported pain: four with intensity 1 and one with intensity 3. The rest of the patients reported no pain. All patients reported subjective general relief at 12 months follow-up.
Conclusions: Levonorgestrel administered intrauterine may be an alternative for the long-term pain-free treatment of patients with endometriosis who wish to postpone pregnancy. Controlled, randomized studies with a truly representative sample size are needed to confirm the findings.


REFERENCES

  1. Eskenazi B, Warner ML. Epidemiology of endometriosis.Obstet Gynecol Clin North Am 1997; 24 (2): 235-58.doi:10.1016/s0889-8545(05)70302-8

  2. Horne AW, Saunders PTK, Abokhrais IM, Hogg L; EndometriosisPriority Setting Partnership Steering Group(appendix). Top ten endometriosis research priorities inthe UK and Ireland. Lancet 2017; 389 (10085): 2191-92.doi:10.1016/S0140-6736(17)31344-2

  3. Giudice LC. Clinical practice. Endometriosis. N Engl J Med2010; 362 (25): 2389-98. doi:10.1056/NEJMcp1000274

  4. Attaran M, Falcone T. Adolescent endometriosis. J MinimInvasive Gynecol 2015; 22 (5): 705-6. doi:10.1016/j.jmig.2015.05.011

  5. Zondervan KT, Becker CM, Missmer SA. Endometriosis.N Engl J Med 2020; 382 (13): 1244-56. doi:10.1056/NEJMra1810764

  6. Meuleman C, Vandenabeele B, Fieuws S, Spiessens C, TimmermanD, D'Hooghe T. High prevalence of endometriosisin infertile women with normal ovulation and normospermicpartners. Fertil Steril 2009; 92 (1): 68-74. doi:10.1016/j.fertnstert.2008.04.056

  7. Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218.Obstet Gynecol. 2020; 135 (3): e98-e109. doi:10.1097/AOG.0000000000003716

  8. Genazzani A, Nisolle M, Petraglia F, Taylor R. EndometriosisPathogenesis, Clinical Impact and Management. Frontiers inGynecological Endocrinology (ISGE Series) 1st ed. 2021; 9: 51-64.

  9. Sieberg CB, Lunde CE, Borsook D. Endometriosis and painin the adolescent- striking early to limit suffering: A narrativereview. Neurosci Biobehav Rev 2020; 108: 866-76.doi:10.1016/j.neubiorev.2019.12.004

  10. Howard FM. The role of laparoscopy in chronic pelvic pain:promise and pitfalls. Obstet Gynecol Surv 1993; 48 (6): 357-87. doi: 10.1097/00006254-199306000-00001

  11. Bafort C, Beebeejaun Y, Tomassetti C, Bosteels J, Duffy JM.Laparoscopic surgery for endometriosis. Cochrane DatabaseSyst Rev 2020; 10 (10): CD011031. doi:10.1002/14651858.CD011031.pub3

  12. Shakiba K, Bena JF, McGill KM, Minger J, Falcone T. Surgicaltreatment of endometriosis: a 7-year follow-up on therequirement for further surgery. Obstet Gynecol 2008;111 (6): 1285-92. doi:10.1097/AOG.0b013e3181758ec6.Erratum in: Obstet Gynecol 2008; 112 (3): 710.

  13. Stratton P, Berkley KJ. Chronic pelvic pain and endometriosis:translational evidence of the relationship andimplications. Hum Reprod Update 2011; 17 (3): 327-46.doi:10.1093/humupd/dmq050

  14. Chen I, Veth VB, Choudhry AJ, Murji A, Zakhari A, BlackAY, Agarpao C, Maas JW. Pre- and postsurgical medicaltherapy for endometriosis surgery. Cochrane DatabaseSyst Rev 2020; 11 (11): CD003678. doi:10.1002/14651858.CD003678.pub3

  15. Ling FW. Randomized controlled trial of depot leuprolidein patients with chronic pelvic pain and clinically suspectedendometriosis. Pelvic Pain Study Group. Obstet Gynecol1999; 93 (1): 51-8. doi:10.1016/s0029-7844(98)00341-x

  16. Sauerbrun-Cutler MT, Alvero R. Short- and long-termimpact of gonadotropin-releasing hormone analoguetreatment on bone loss and fracture. Fertil Steril 2019;112 (5): 799-803. doi:10.1016/j.fertnstert.2019.09.037

  17. Nisolle-Pochet M, Casanas-Roux F, Donnez J. Histologicstudy of ovarian endometriosis after hormonal therapy.Fertil Steril 1988; 49 (3): 423-6. doi:10.1016/s0015-0282(16)59766-0. Erratum in: Fertil Steril 1988; 50 (1):

  18. 184.18. Surrey ES, Hornstein MD. Prolonged GnRH agonist andadd-back therapy for symptomatic endometriosis: longtermfollow-up. Obstet Gynecol 2002; 99 (5 Pt 1): 709-19.doi:10.1016/s0029-7844(02)01945-2

  19. Pickar JH, Boucher M, Morgenstern D. Tissue selectiveestrogen complex (TSEC): a review. Menopause 2018; 25(9): 1033-45. doi:10.1097/GME.0000000000001095

  20. Vos RM, Krebbers SF, Verhoeven CH, Delbressine LP. The invivo human metabolism of tibolone. Drug Metab Dispos2002; 30 (2): 106-12. doi:10.1124/dmd.30.2.106

  21. Timmer CJ, Verheul HA, Doorstam DP. Pharmacokineticsof tibolone in early and late postmenopausal women. BrJ Clin Pharmacol 2002; 54 (2): 101-6. doi:10.1046/j.1365-2125.2002.01619.x

  22. Vercellini P, Viganò P, Somigliana E. The role of thelevonorgestrel-releasing intrauterine device in the managementof symptomatic endometriosis. Curr OpinObstet Gynecol 2005; 17 (4): 359-65. doi: 10.1097/01.gco.0000175353.03061.7f

  23. Song SY, Park M, Lee GW, Lee KH, Chang HK, Kwak SM, YooHJ. Efficacy of levonorgestrel releasing intrauterine systemas a postoperative maintenance therapy of endometriosis:A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2018;231: 85-92. doi:10.1016/j.ejogrb.2018.10.014

  24. Shim JY, Laufer MR. Adolescent endometriosis: an update.J Pediatr Adolesc Gynecol 2020; 33 (2): 112-9. https://doi.org/10.1016/j.jpag.2019.11.011

  25. Petta CA, Ferriani RA, Abrao MS, Hassan D, Rosa E Silva JC,Podgaec S, Bahamondes L. Randomized clinical trial of alevonorgestrel-releasing intrauterine system and a depotGnRH analogue for the treatment of chronic pelvic painin women with endometriosis. Hum Reprod 2005; 20 (7):1993-98. doi:10.1093/humrep/deh869

  26. Herrero V, Delgado B, Bandres M, Ramírez I, Capdevila G.Valoración del dolor. Revisión comparativa de escalas ycuestionarios. Rev Soc Esp 2018; 25 (4): 228-36.

  27. Plantilla de encuesta https://es.dreamstime.com/plantillade-encuesta-retroalimentaci%C3%B3n-vector-diez-escalaemoci%C3%B3n-color-sonr%C3%ADe-enojado-feliz-conn%C3%BAmeros-aislados-en-fondo-image191261452

  28. ESHRE Endometriosis Guideline Development GroupGuideline Endometriosis – 2022file:///C:/Users/Home/Downloads/ESHRE%20GUIDELINE%20ENDOMETRIOSIS%202022_2%20(3).pdf

  29. Guo SW. Recurrence of endometriosis and its control.Hum Reprod Update 2009; 15 (4): 441-61. doi:10.1093/humupd/dmp007

  30. Weir E, Mustard C, Cohen M, Kung R. Endometriosis: whatis the risk of hospital admission, readmission, and majorsurgical intervention? J Minim Invasive Gynecol 2005; 12(6): 486-93. doi:10.1016/j.jmig.2005.09.001

  31. Cheong Y, Tay P, Luk F, Gan HC, Li TC, Cooke I. Laparoscopicsurgery for endometriosis: How often do we needto re-operate? J Obstet Gynaecol 2008; 28 (1): 82-5.doi:10.1080/01443610701811761

  32. Gallagher JS, Missmer SA, Hornstein MD, Laufer MR, GordonCM, DiVasta AD. Long-term effects of gonadotropinreleasinghormone agonists and add-back in adolescentendometriosis. J Pediatr Adolesc Gynecol 2018; 31 (4):376-81. doi: 10.1016/j.jpag.2018.03.004

  33. Song SY, Park M, Lee GW, Lee KH, Chang HK, Kwak SM, YooHJ. Efficacy of levonorgestrel releasing intrauterine systemas a postoperative maintenance therapy of endometriosis:A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2018;231: 85-92. doi:10.1016/j.ejogrb.2018.10.014

  34. Osteen KG, Bruner-Tran KL, Eisenberg E. Reduced progesteroneaction during endometrial maturation: a potential riskfactor for the development of endometriosis. Fertil Steril2005; 83 (3): 529-37. doi: 10.1016/j.fertnstert.2004.11.026

  35. Tokushige N, Markham R, Russell P, Fraser IS. High densityof small nerve fibres in the functional layer of the endometriumin women with endometriosis. Hum Reprod 2006;21 (3): 782-7. doi:10.1093/humrep/dei368

  36. Nakamura M, Katsuki Y, Shibutani Y, Oikawa T. Dienogest, asynthetic steroid, suppresses both embryonic and tumorcell-induced angiogenesis. Eur J Pharmacol 1999; 386 (1):33-40. doi:10.1016/s0014-2999(99)00765-7

  37. Vercellini P, Fedele L, Pietropaolo G, Frontino G, SomiglianaE, Crosignani PG. Progestogens for endometriosis: forwardto the past. Hum Reprod Update 2003; 9 (4): 387-96.doi:10.1093/humupd/dmg030

  38. Lockhat FB, Emembolu JO, Konje JC. The evaluationof the effectiveness of an intrauterine-administeredprogestogen (levonorgestrel) in the symptomatictreatment of endometriosis and in the staging of thedisease. Hum Reprod 2004; 19 (1): 179-84. doi:10.1093/humrep/deh004

  39. De los Ríos M, et al. Manejo de los síntomas dolorosos dela endometriosis con dispositivo intrauterino de levonorgestrelen una paciente con pelvis congelada: reporte decaso. Rev Colomb Obstet Ginecol 2006; 57 (3): 211-15.https://doi.org/10.18597/rcog.495

  40. Egekvist AG, Marinovskij E, Forman A, Kesmodel US,Graumann O, Seyer-Hansen M. Conservative treatmentof rectosigmoid endometriosis: A prospective study. ActaObstet Gynecol Scand 2019; 98 (9): 1139-47. doi:10.1111/aogs.13619.

  41. Margatho D, Carvalho NM, Bahamondes L. Endometriosisassociatedpain scores and biomarkers in users of theetonogestrel-releasing subdermal implant or the 52-mglevonorgestrel-releasing intrauterine system for up to 24months. Eur J Contracept Reprod Health Care 2020; 25 (2):133-40. doi:10.1080/13625187.2020.1725461

  42. Carvalho N, Margatho D, Cursino K, Benetti-Pinto CL,Bahamondes L. Control of endometriosis-associated painwith etonogestrel-releasing contraceptive implant and52-mg levonorgestrel-releasing intrauterine system: randomizedclinical trial. Fertil Steril 2018; 110 (6): 1129-36.doi:10.1016/j.fertnstert.2018.07.003.




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Ginecol Obstet Mex. 2023;91