( S ) Few studies of medical therapies for endometriosis report outcomes that are relevant to patients , and many women gain only limited or intermittent benefit from treatment
OBJECTIVE To assess patient response rates to medical therapies used to treat endometriosis-associated pain .
Combined surgical and hormone therapy for endometriosis is the most effective treatment: prospective, randomized, controlled trial.
STUDY OBJECTIVE To evaluate 3 therapy strategies : hormone therapy , surgery , and combined treatment . DESIGN Prospect i ve , r and omized , controlled study ( Canadian Task Force classification I ) . SETTING University-based teaching hospital . PATIENTS Four hundred fifty patients with genital endometriosis , aged 18 to 44 years , before first laparoscopy . INTERVENTIONS Patients were r and omly assigned to 1 of 3 treatment groups : hormone therapy , surgery , or combined treatment . Patients were reevaluated at second-look laparoscopy , at 2 to 2 months after 3-month hormone therapy in groups 1 and 3 and at 5 to 6 months in group 2 ( surgical treatment alone ) . Outcome data were focussed on the endometriosis stage , recurrence of symptoms , and pregnancy rate . MEASUREMENTS AND MAIN RESULTS All treatment options , independent of the initial Endoscopic Endometriosis Classification stage , achieved an overall cure rate of ≥50 % . A cure rate of 60 % was achieved with the combined treatment , 55 % with exclusively hormone therapy , and 50 % with exclusively surgical treatment . Recurrence of symptoms was lowest in patients who received combined treatment . Significant benefit was achieved for dysmenorrhea and dyspareunia . An overall pregnancy rate of 55 % to 65 % was achieved , with no significant difference between the therapeutic options . CONCLUSION In the quest to find the most effective treatment of genital endometriosis , this clinical r and omized study shows the lowest incidence of recurrence with combined surgical and medical treatment and improved pregnancy rate in any medically treated patients with or without surgery . The highest cure rate ( Endoscopic Endometriosis Classification stage 0 ) for endometriosis was also achieved in the combined treatment group
( S ) Few studies of medical therapies for endometriosis report outcomes that are relevant to patients , and many women gain only limited or intermittent benefit from treatment
OBJECTIVE To assess patient response rates to medical therapies used to treat endometriosis-associated pain .