Clinical efficacy of surgical treatment on patients with ovarian endometriosis cysts

DU Lingyue; SONG Yuxia; ZHANG Weican

doi:10.3969/j.issn.1002-7386.2025.05.008

Abstract：Objective To study the effects of the application of leuprolide and dienogest on ovarian function and dysmenorrhea in patients with ovarian endometriosis cysts after surgery.Methods From January 2022 to December 2022,120 patients who underwent laparoscopic cystectomy for ovarian endometriosis in the hospital were randomly divided into 3 groups:Group A,postoperative application of oral dienogest 2 mg once a day for 24 weeks;Group B,postoperative application of 6 subcutaneous injections of leuprolide 3.75mg once every 4 weeks,for a total of 24 weeks;Group C,postoperative application of 3 subcutaneous injections of leuprolide 3.75 mg once every 4 weeks,for a total of 12 weeks,followed by oral dienogest 2 mg once a day,for 12 weeks.Serum cancer antigen 125(CA125),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),anti-Müllerian hormone(AMH),and sinus follicle count were detected.After 6 months of treatment,transvaginal ultrasound was performed to observe the relapse of ovarian endometriosis cysts.Results CA125 levels after treatment and 6 months of treatment in A,B and C groups were significantly lower than those before treatment(P＜0.05),and there was no significant difference among the three groups(P＞0.05).After treatment and 6 months of treatment,the maximum meridian of ovarian endometriosis cyst significantly decreased than that before the treatment,and there was no significant difference among the three groups(P＞0.05).After treatment,E2 level significantly decreased in the three groups than that before treatment,which was significantly lower in group B than group A and C(P＜0.05),but comparable between group A and C(P＞0.05).After 6 months of treatment,E2 level significantly increased in the three groups(P＜0.05),but comparable with that before treatment(P＞0.05).After treatment,FSH and LH levels in group B significantly increased compared with those before treatment(P＜0.05).FSH and LH levels in group A and C were significantly reduced after treatment and 6 months of treatment than those before treatment(P＜0.05).After treatment,AMH level in group B decreased significantly compared with that before treatment(P＜0.05),while that in group A and C before and after treatment was comparable(P＞0.05).After 6 months of treatment,AMH levels in the three groups were comparable with those before treatment(P＞0.05).After treatment,the antral follicle count in group A and C significantly increased than that before treatment(P＜0.05),but comparable in group B(P＞0.05).After 6 months of treatment,it significantly increased than that before treatment in the three groups(P＜0.05).The scores of dyspareunia,dysmenorrhea,and non-menstrual pain after treatment and 6 months of treatment in the three groups were significantly lower than those before treatment(P＜0.05).Fourteen(14/40)cases in group B presented hot flashes,sweating,palpitation,fatigue and other symptoms;Five cases(5/40)in group A had nausea,vomiting,irregular vaginal bleeding and other symptoms,and no symptoms such as hot flashes,sweating,palpitation,and fatigue were observed.Seven(7/40)cases in group C experienced irregular vaginal bleeding,hot flashes,sweating,nausea and other symptoms.Conclusion The application of dienogest and leuprolide for postoperative ovarian endometriosis cyst patients can inhibit its relapse,improve ovarian function,and alelviate the symptoms of dyspareunia,dysmenorrhea and non-menstrual pain.Dienogest has less side effects than leuprolide.