Long Term Outcome of Patients with Endometriosis on Medical Treatment

Abstract

Objective: To evaluate long term outcome of patients with endometriosis on medical treatment
(OCP's, progestin, clomiphene citrate according to need of patients), in terms of symptomatic
relief, successful conception, recurrence & treatment failure.
Material & Methods: This quasi experimental study was conducted in Shalamar Hospital
Lahore. All patients who had confirmed diagnosis of endometriosis by laparoscopy or by
laparotomy were included in the study after informed consent. Type of medical management was
decided according to the need of the patients. The patients who did not want to conceive were
given medical treatment in the form of combined oral contraceptive pills or progesterone. Patients
who wanted to conceive, were given clomiphene citrate. Patients were followed up for 1 to 9 years.
Study outcome was expressed in terms of symptomatic relief, pregnancy, recurrence and
treatment failure. Data was analyzed using SPSS version 16.
Results: Initially, there were 94 patients who had confirmed endometriosis and were included in
the study. Out of these,18 patients lost follow up, and were excluded from study. The mean age of
these patients was 25±4.73 years and 50 percent presented with pelvic pain and 36% with
infertility. They were followed for 1-9 years. The mean duration of follow up was 4.37±2.29 years.
61.8% cases became symptom free, 15.8% conceived successfully, whereas 9.2% had
persistence of pain. 11.8% had recurrence rate over 12-14 months after discontinuation of medical
treatment.
Conclusion: Long term follow up of patients with endometriosis showed that medical treatment
of endometriosis with COCPs, progestogens, and clomiphene citrate has promising results with
less then 20% cases requiring other modes of treatment.