Copenhagen, Denmark 19 - 22 June 2005

Cyclic and continuous oral contraceptive after laparoscopic treatment of endometriomas R Seracchioli University of Bologna Endocrinologia Ginecologica Bologna Italy

Introduction
We sought to evaluate if the postoperative therapy with monofasic, combined, low dose oral contraceptives in a cyclic or continuous administration may give different results in terms of endometriomas recurrence and on persistence-recurrence of associated pain symptoms after laparoscopic
treatment.

Materials and methods
In a prospective randomized trial, 87 patients who were not attempting to conceive, aged 20–40 years, underwent laparoscopic excision of ovarian endometriomas between January 1999 and December 2003.
Surgery was followed by either postoperative administration of low dose oral contraceptive in a cyclic (44 patients: group A) or continuous (43 patients: group B) manner for a minimum of 12 months. At 3 months and 6 months after surgery, and then every 6 months thereafter both groups underwent ultrasonographic examination for possible evidence of endometrioma recurrence. An evaluation of the absence, persistence, or recurrence of pain symptoms was also carried out. Degree of satisfaction with cyclic or continuous OC use was tested.

Results
Three patients in group A and two in group B did not complete the study. After a mean follow-up of 25 months (range 12–52 months), there were 6 (14.6%) endometrioma recurrence in group A, and 3 (7.3%) in group B. This difference was not statistically significant.

The mean±SD dysmenorrhea visual analog scale were 34±15 in group A and 22±17 in group B. The mean±dyspareunia were 22±12 in group A and 15±6 in group B. Data about chronic pelvic pain were 25±13 and 17±10, respectively.

Conclusions
All these data were not statistically significant, but suggest a positive trend of continuous administration versus the cyclic one. The study is ongoing.

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