Combination Drug and Surgical Treatment
Three randomized trials have evaluated postoperative medical therapy as a means of providing further pain relief in women with endometriosis. In a study comparing the effect of danazol, medroxyprogesterone, and placebo given postoperatively for six months to 60 women with advanced endometriosis, the pain scores in women given either drug were significantly lower than the scores in those given placebo. In a study comparing treatment for six months with a
GnRH agonist or placebo in 109 women, the number of women who required retreatment within two years was lower in the GnRH-agonist group (31 percent, as compared with 57 percent in the placebo group), but there was no difference in the pain scores between these two groups. Another study, in which a GnRH agonist or placebo was given to 75 women
for three months after surgery, also found no difference in pain scores during the one-year follow-up period. On balance, however, there seems to be some benefit of postoperative drug therapy.