腹腔镜子宫骶神经切断术治疗子宫内膜异位症疼痛的多中心前瞻性对照研究

目的:研究、评价腹腔镜子宫骶神经切断术(LUNA)治疗子宫内膜异位症疼痛的安全性和有效性。方法:应用多中心随机对照的前瞻性研究方法,收集82例中、重度痛经患者的临床资料,分析比较同时行LUNA对子宫内膜异位症保守手术后各种疼痛缓解率的影响,并评价手术的安全性。结果:71例患者纳入分析,LUNA组51例,对照组20例。LUNA组术后痛经缓解率90.2%,高于对照组的60.0%(P=0.02);LUNA组性交痛术后缓解率85.7%,高于对照组的50.0%(P=0.048);LUNA组慢性盆腔痛(CPP)缓解率100%,高于对照组的71.4%(P=0.041),差异均有统计学意义。手术安全性:LUNA组患者手术时间延长,术后肛门排气时间延长,但两组术中出血量、术后体温、住院时间、总住院费用以及手术费用均无统计学差异。所有研究对象均无手术并发症发生。结论:内异症保守手术同时行LUNA手术,术后2年内能有效的缓解内异症的各种疼痛。     

左炔诺孕酮宫内缓释系统治疗子宫腺肌病的疗效

目的观察左炔诺孕酮宫内缓释系统（LNG-IUS）治疗子宫腺肌病所致痛经的临床疗效。方法对56例子宫腺肌病所致痛经患者给予放置LNG-IUS治疗。并进行前后自身对照,比较放置前后视觉模拟评分法（VAS）和口述评分法（VRS）,以评估痛经和深部性交痛改善情况,并观察月经、子宫大小及副反应情况。结果放置LNG-IUS后3个月,55例（98.2%）患者痛经症状显著缓解或完全消失,月经量显著减少。与放置前比较,放置后3、6、9、12个月VAS和VRS评分明显下降（P〈0.01）;月经周期和子宫体积差异无统计学意义（P〉0.05）。17例（30.4%）深部性交痛患者症状明显缓解;36例（64.3%）贫血患者血红蛋白水平恢复正常。结论 LNG-IUS能有效控制子宫腺肌病患者的疼痛,减少月经量,疗效显著。     

腹腔镜下局限性子宫腺肌症病灶切除术后联合GnRH-a、曼月乐治疗的效果分析

目的 探讨腹腔镜下局限性子宫腺肌症病灶切除术后联合促性腺激素释放激素-a(GnRH-a)、曼月乐治疗的效果分析。方法 选取74例子宫腺肌症患者,按照随机抽签法分为对照组与试验组,每组37例。两组患者均接受腹腔镜下局限性子宫腺肌症病灶切除术,对照组患者在此基础上联合GnRH-a治疗,试验组在此基础上联合曼月乐治疗。比较两组患者的手术前后月经周期、经期和经量、疼痛情况及子宫体积变化。结果 试验组患者术后24个月的月经周期稍短于对照组,但差异无差异意义（P>0.05）。试验组患者术后24个月的经期明显短于对照组,经量明显少于对照组（P<0.05）。试验组患者术后12、24个月视觉模拟评分法（VAS）评分均明显低于对照组,术后3个月、术后12个月子宫体积均明显大于对照组,术后24个月子宫体积明显小于对照组（P<0.05）。结论 子宫腺肌症患者接受腹腔镜下局限性子宫腺肌症病灶切除术后,联合曼月乐的治疗效果优于联合GnRH-a治疗方案,有助于恢复患者术后子宫内环境,抑制子宫肌瘤复发,确保患者手术治疗的安全性。     

子宫腺肌病与子宫肌瘤310例的临床相关及对比分析

目的 对310例子宫腺肌病与子宫肌瘤患者进行临床相关及对比分析，以利于指导临床治疗与诊断。方法回顾性分析了310例子宫腺肌病与子宫肌瘤的临床资料。结果 两者大多数见于30—50岁生育年龄的妇女（P〉0．05）。而与子宫肌瘤相区别的是，子宫腺肌病的临床表现为痛经、盆腔深部痛或性交痛，盆腔检查子宫增大多〈2个半月，活动度差，后穹隆有触痛，血清CA125增高，术前误诊率高。两者相比，差异有显著性（P〈0．05）。结论 二者共同的发病因素可能是高雌激素刺激。术前诊断子宫腺肌病应在结合病史、临床症状及盆腔检查的同时，结合B超、血清CA125测定等检查，进行综合判断。     

盆腔子宫内膜异位症患者的疼痛症状分析

调查１９９１年２月至１９９３年１月在我院妇科在住院的３８３例生育年龄患者的疼痛症状，其中子宫内膜异位异（异位症）患者１９２例（异位症组），其它疾病患者１９１例（对照组）。结果，痛经，非经期下腹或盆腔痛，性交痛，经期肛门坠痛的发生率，异位症组分别为６５．６％，４４．３％，３０?２％和３２．３％，对照组分别为３７．７％、３３．０％、２０．９％和２０．４％；异位症组的疼痛发生率均分别高于对照组，两者比较     

子宫内膜切除术治疗子宫腺肌病28例分析

子宫内膜切除术是通过去除子宫内膜，达到减少经血量目的的腔内手术，主要适应症为功血，可同时切除突向宫腔的肌瘤。腺肌病因有进一步手术的指征，故非适应症。在１９９０年５月至１９９３年４月所施２０８例子宫内膜切除术中，经术中镜下所见，Ｂ超监视示灌流液进入肌层及病理证实，发现子宫腺肌病２８例。经术后３～３４个月随访，２例子宫切除，２６例疗效满意，成功率９２．８６％，月经均有改善，贫血治愈，１８例术前痛经者７７．８％术后痛经消失，２２．２％减轻。文中就子宫内膜切除术能治疗子宫腺肌病的机制进行了探讨，提出子宫腺肌病多发生于育龄妇女，子宫切除的治疗原则常使患者望而却步，若术前能对此病正确诊断，选择轻症患者行子宫内膜切除术，有可能成为代替子宫切除治疗子宫腺肌病的全新方法。     

子宫腺肌症318例诊治分析

目的 分析近年来子宫腺肌症的发病情况、临床表现、诊断和治疗。方法 回顾性分析1997年1月～1999年12月本院收治的318例子宫腺肌症患者的临床资料。结果 318例子宫腺肌症占我院同期妇科住院人数的5.7％、妇科手术子宫切除的20.9％。术前痛经者217例(68.2％),月经过多者132例(41.5％);术前诊断为子宫腺肌症192例,诊断符合率为60.4％,B超诊断符合率为60.5％,血CA125测定阳性率为72.3％。除2例行腺肌瘤剔除术外,全部患者均行子宫切除术,其中33例术前曾使用内美通、丹那唑、米非司酮、雌孕激素类及雄激素等治疗达3个月以上,80.0％痛经明显缓解,但75.0％患者停药后第1个月经周期痛经即复发。结论子宫腺肌症目前仍以手术治疗为主,治疗子宫内膜异位症的常用药物对子宫腺肌症痛经均有效,但停药后腺肌症患者痛经易复发。     

腹腔镜下多术式联合治疗子宫腺肌病的临床观察

目的:探讨腹腔镜下子宫动脉阻断术(UAB)、子宫腺肌病病灶切除术、子宫神经去除术(LUNA))联合应用治疗子宫腺肌病(AM)的临床效果。方法:80例AM患者随机分为观察组38例行UAB+病灶切除术+LUNA,对照组42例行腹腔镜子宫腺肌病病灶切除术,观察两组围手术期情况及术后月经量、子宫体积、痛经评分及血清CA125水平变化。结果:①观察组手术时间(76.5±11.7分钟)长于对照组(52.3±12.8分钟),差异有统计学意义(P0.05);对照组术后血红蛋白下降较观察组明显(P0.05)。②观察组和对照组,术后月经量、痛经评分、子宫体积、血CA125均较术前明显下降(P0.05),术后12个月起两组间痛经评分、子宫体积、CA125同期比较,差异有统计学意义(P0.05),术后36个月两组痛经缓解率(90.9%vs69.4%)、复发率(9.1%vs 30.6%)比较,差异有统计学意义(P0.05)。结论:UAB、病灶切除术、LUNA联合治疗AM近期安全有效,可提高痛经缓解率,延缓复发。     

腹腔镜下单极电消融术治疗子宫腺肌病术后痛经缓解程度的分析

目的 探讨腹腔镜下单极电消融术治疗子宫腺肌病痛经缓解的疗效。方法 对20例子宫腺肌病患者行腹腔镜下单极电消融术，观察其痛经缓解情况，并将治疗前后痛经程度的各项指标根据慢性疼痛分级问卷法进行评分和统计学分析。结果 35％的患者术后第1个月痛经即消失；45％的患者术后3个月痛经消失；20％的患者术后随着月经周期的推移而逐渐缓解。平均观察4～8个月经周期，17例（85％）完全缓解，3例（15％）明显缓解，无部分缓解和无效病例。结论 腹腔镜下单极电消融术治疗子宫腺肌病，痛经缓解明显。     

子宫内膜异位症患者疼痛与盆腔病灶解剖分布的关系

目的研究子宫内膜异位症（内异症）患者疼痛症状与盆腔病灶解剖分布特点的关系。方法详细记录130例内异症患者痛经、慢性盆腔痛（CPP）、性交痛及排便痛的发生情况。以腹腔镜检查为诊断标准。评价疼痛症状包括痛经、CPP、性交痛及排便痛与盆腔内不同部位内异症病灶的关系。结果130例内异症患者中,痛经100例（76．9％）,无痛经30例（23．1％）。轻、中度和重度痛经者分别为27例（20．8％）、41例（31．5％）、32例（24．6％）,性交痛46例（35．4％）,CPP45例（34．6％）,排便痛67例（51．5％）。痛经者深部宫骶韧带结节、阴道直肠隔结节发生率分别为45．0％、16．0％,无痛经者深部宫骶韧带结节、阴道直肠隔结节发生率为13．3％、0,两者分别比较,差异均有统计学意义（P=0．00、P=0．01）;痛经者与无痛经者比较,子宫直肠窝封闭的比例增加（分别为41．0％、10．0％,P=0．00）,深部浸润型内异症（DIE）比例增加（分别为51．0％、16．7％,P=0．00）。痛经程度与宫骶韧带结节的数目（P=0．005,r=0．302）、宫骶韧带结节浸润深度（P=0．017,r=0．227）呈线性相关。痛经伴卵巢内异症囊肿患者中,发生中、重度盆腔粘连的比例增加（分别为29．1％、8．3％,P=0．029）。与无CPP的患者比较,CPP患者深部宫骶韧带结节（分别为51．1％、30．6％,P=0．018）以及DIE（分别为57．8％、35．3％,P=0．011）比例明显升高。与无排便痛的患者比较,排便痛患者深部宫骶韧带结节（分别为46．3％、28．6％,P=0．028）、阴道直肠隔结节（分别为19．4％、4．8％,P=0．01）、子宫直肠窝封闭（分别为44．8％、22．2％,P=0．005）以及DIE（分别为53．7％、31．7％,P=0．01）的比例升高。阴道直肠隔结节是性交痛的独立危险因素（OR=3．61）。结论痛经、CPP、性交痛以及排便痛与盆腔内异症病灶的部位和浸润深度有关,位于盆腔后部的深部浸润病灶以及子宫直肠窝封闭与疼痛症状关系密切。     

Successful treatment of deep dyspareunia and primary dysmenorrhea with laparoscopic uterosacral nerve ablation (LUNA) procedure

Deep dyspareunia, often described as pain resulting from pelvic thrusting during sexual intercourse, is relatively common and has many causes. To date, feasible surgical interventions for deep dyspareunia are very rare. The two procedures which have been mentioned in the literature for the treatment of deep dyspareunia were laparoscopic uterosacral ligament ablation (LUNA) and uterine ventrosuspension. We report the case of a young female patient, aged 32, gravida 3, parity 2, presenting with deep dyspareunia and primary dysmenorrhea for 4 years. She had both subjective and objective improvements for dyspareunia and primary dysmenorrhea following LUNA operation. Further large-scaled randomized controlled trial is mandatory to verify the surgical effect of LUNA operation for patients with deep dyspareunia.     

A double-blind randomised controlled trial of laparoscopic uterine nerve ablation for women with chronic pelvic pain

OBJECTIVE: To determine the effectiveness of laparoscopic uterine nerve ablation (LUNA) for chronic pelvic pain in women with endometriosis and women with no laparoscopic evidence of endometriosis. DESIGN: A prospective double-blind randomised controlled trial (RCT). SETTING: Single-centre, secondary-level gynaecology outpatient service and tertiary-level pelvic pain and endometriosis outpatient service in Auckland, New Zealand. POPULATION: One hundred and twenty-three women undergoing laparoscopy for investigation and management of chronic pelvic pain, 56 with no laparoscopic evidence of endometriosis and 67 with endometriosis. METHODS: Women were randomised from the two populations, firstly those with no evidence of endometriosis and secondly those undergoing laparoscopic surgical treatment for endometriosis, to receive LUNA or no LUNA. Participant and assessor blinding was employed. Follow up for pain outcomes was undertaken at 24 hours, 3 months and 12 months. MAIN OUTCOME MEASURES: Changes in non-menstrual pelvic pain, dysmenorrhoea, deep dyspareunia and dyschezia were assessed primarily by whether there was a decrease in visual analogue score for these types of pain of 50% or more from baseline and additionally whether there was a significantly different change in median visual analogue score. The numbers requiring further surgery or starting a new medical treatment for pelvic pain and complications were also measured. RESULTS: There was a significant reduction in dysmenorrhoea at 12 month follow up in women with chronic pelvic pain in the absence of endometriosis who underwent LUNA (median change in visual analogue scale (VAS) from baseline -4.8 versus-0.8 (P= 0.039), 42.1%versus 14.3% experiencing a successful treatment defined as a 50% or greater reduction in visual analogue pain scale for dysmenorrhoea (P= 0.045). There was no significant difference in non-menstrual pelvic pain, deep dyspareunia or dyschezia in women with no endometriosis undergoing LUNA versus no LUNA. The addition of LUNA to laparoscopic surgical treatment of endometriosis was not associated with a significant difference in any pain outcomes. CONCLUSIONS: LUNA is effective for dysmenorrhoea in the absence of endometriosis, although there is no evidence of effectiveness of LUNA for non-dysmenorrhoeic chronic pelvic pain or for any type of chronic pelvic pain related to endometriosis.     

The efficacy of laparoscopic uterosacral nerve ablation (LUNA) in the treatment of unexplained chronic pelvic pain: a randomized controlled trial

The aim of this work is to explore the efficacy , safety, and patients' satisfaction of laparoscopic uterosacral nerve ablation (LUNA) in relief of pain in women with chronic pelvic pain in whom diagnostic laparoscopy reveals either no pathology or mild endometriosis (AFS score ≤5). The study was a prospective, single-blind, randomized trial with 12 months follow-up. It was conducted at the endoscopy unit of the Gynecology Department of El Minia University Hospital, Egypt. One hundred ninety Egyptian women consented to participate in the study. These eligible patients were randomized using computer-generated tables and were divided into two equal groups, including the control group (diagnostic laparoscopy with no pelvic denervation) and the study group (diagnostic laparoscopy plus LUNA). Diagnostic laparoscopy with or without laparoscopic uterosacral nerve ablation was done. There were no statistically significant difference between both groups regarding the efficacy and the overall success rate (between group I and group II, it was 77.64%, 76.47%, and 74.11% versus 79.06%, 75.58%, and 73.25% at 3, 6, and 12 months, respectively) and the cumulative patients' satisfaction rate (it was 74.11%, 74.11%, and 71.76% versus 75.58%, 75.58%, and 72.09% at 3, 6, and 12 months between group I and group II, respectively; P ≤ 0.05). There was no statistically significant difference between both groups as regards the effectiveness of LUNA in the treatment of primary (spasmodic) and secondary (congestive) dysmenorrhea (P ≤ 0.05), while there was a statistically significant difference between both groups in the treatment of dyspareunia (P ≥ 0.05). LUNA can be a last alternative option in well-selected patients for control of chronic pelvic pain without endometriosis; however, its effectiveness may not extend to other indications. Also, preliminary experience in the treatment of primary deep dyspareunia presents a promising perspective on the management of deep dyspareunia, especially if it will involve a team of social, psychological, and gynecological specialists.     

Presacral neurectomy for chronic pelvic pain

Over an eight-year period, 50 presacral neurectomies were performed at Madigan Army Medical Center for chronic pelvic pain failing response to medical management. Each hospital record was reviewed and 45 patients answered a questionnaire grading the severity of their pain from 0 to 10 for dysmenorrhea, dyspareunia, and other pelvic pain before and after surgery. The results showed success rates of 73% in relieving dysmenorrhea, 77% in relieving dyspareunia, and 63% in relieving other pelvic pains. The addition of a bilateral uterosacral ligament resection to the presacral neurectomy did not increase the success rate. There was an 18% lateral pelvic pain recurrence rate, and no recurrence of dysmenorrhea. Complications occurred in 4%.     

Effectiveness of presacral neurectomy in women with severe dysmenorrhea caused by endometriosis who were treated with laparoscopic conservative surgery: a 1-year prospective randomized double-blind controlled trial

OBJECTIVE: The purpose of this study was to assess the effectiveness of presacral neurectomy in women with severe dysmenorrhea caused by endometriosis that was treated with conservative surgical intervention. STUDY DESIGN: One hundred forty-one sexually active women of fertile age with chronic severe dysmenorrhea caused by endometriosis were treated with conservative laparoscopic surgery. Patients were assigned randomly to not receive (group A) or receive (group B) presacral neurectomy. At 6 and 12 months after the surgical procedures, the cure rate was evaluated in each patient. The frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain were also evaluated at the same time intervals. RESULTS: The cure rate was significantly higher in group B compared with group A at a follow-up examination at 6 months (87.3% vs 60.3%) and 12 months (85.7% vs 57.1%). At follow-up visits, the frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain were significantly lower in both groups compared with baseline values; in particular, significantly lower values were observed in group B versus group A for the severity. CONCLUSION: Presacral neurectomy improves the cure rate in women who are treated with conservative laparoscopic surgery for severe dysmenorrhea caused by endometriosis.     

Endometriosis in patients with chronic pelvic pain: is staging predictive of the efficacy of laparoscopic surgery in pain relief?

BACKGROUND/AIMS: Endometriosis is considered an important cause of chronic pelvic pain. Despite its high prevalence, controversy still exists regarding the true association between the extent of endometriosis and the severity of symptoms. We conducted this prospective study to investigate the association between the stage of endometriosis and type and severity of pain, and to evaluate the efficacy of laparoscopic surgery in pain relief. METHODS: Ninety-five patients complaining of chronic pain were diagnosed with endometriosis and were treated with laparoscopic surgery. The severity of pain was assessed in patients with an endometriosis AFS (American Fertility Society) score less than 16 (group 1) and those with an AFS score greater than or equal to 16 (group 2), preoperatively and 6 months after surgery, using a visual pain scale. Any reduction in pain scores by 2 points or more was considered to be an improvement. RESULTS: Dysmenorrhea and deep dyspareunia, were significantly more frequent in patients of group 2. Preoperative pain scores were significantly higher for dysmenorrhea (p = 0.0022) and deep dyspareunia (p < 0.0001) but not for non-menstrual pain in group 2. Deep dyspareunia was correlated with the presence of dense pelvic adhesions. After surgery, dysmenorrhea improved in 43% of cases in group 1, vs. 66% of cases in group 2 (p = 0.0037). For deep dyspareunia, improvement was reported by 33% in group 1, vs. 67% in group 2 (p = 0.074). Improvement in non-menstrual pain was not significantly different between the two groups (67% vs. 56%). CONCLUSIONS: Advanced endometriosis is more frequently related to dysmenorrhea and deep dypareunia in comparison to early disease. Laparoscopic surgery may offer relief or improvement in the majority of patients with endometriosis and chronic pelvic pain. Cases with advanced disease seem to benefit the most.     

Histopathologic findings on uterosacral ligaments in women with chronic pelvic pain and visually normal pelvis at laparoscopy

STUDY OBJECTIVE: To determine the prevalence and type of microscopic findings on laparoscopically resected uterosacral ligaments in women with chronic pelvic pain and no visible pelvic disease. The effect of this procedure on the patients' level of pain also was assessed as a secondary objective. DESIGN: Prospective follow-up (Canadian Task Force classification II-2). SETTING: University-affiliated hospital. PATIENTS: Twenty-seven premenopausal women undergoing diagnostic laparoscopy for chronic pelvic pain had a normal pelvis on visual inspection. All patients underwent resection and histologic evaluation of the uterosacral ligaments. Pain relief was evaluated by use of a questionnaire administered before and at 3, 6, and 12 months after surgery. MEASUREMENTS AND MAIN RESULTS: Microscopic examination identified endometriosis in 2 (7.4%), endosalpingiosis in 3 (11.1%), and inflammation in 14 (51.9%) patients. Laparoscopic uterosacral ligament resection was associated with a reduction in dysmenorrhea (p < or = .001), with 14 (52%) patients reporting improved or resolved symptoms. There was a statistically significant decrease in dyspareunia (p < or = .01) and in the severity of noncyclical pain (p < or = .002). Thirty-five percent of patients no longer required medication for pain control (p < or = .005). The number of days needed off work also decreased. CONCLUSION: Despite normal laparoscopic appearance, microscopic endometriosis, endosalpingiosis, and inflammatory changes were found in uterosacral ligaments in 17 (63%) women with chronic pelvic pain. Laparoscopic resection of uterosacral ligaments improved dysmenorrhea, dyspareunia, and noncyclical pain and decreased the number of days lost from work, as well as the proportion of patients who required medication for pain control.     

子宫内膜异位症患者盆腔粘连与疼痛的相关性

目的 探讨子宫内膜异位症(内异症)患者中盆腔粘连的发生率及其与疼痛症状的相关性. 方法 分析2003年1月至2007年12月间480例内异症患者盆腔粘连及痛经、慢性盆腔痛(CPP)、性交痛与排便痛的发生情况,评价内异症患者的盆腔粘连与疼痛症状之间的相关性.根据美国生育学会1985年修订的内异症分期标准(r-AFS)分为Ⅰ期155例,Ⅱ期33例,Ⅲ期108例,Ⅳ期184例. 结果 (1)480例内异症患者中,72.3%(347/480)存在盆腔粘连;Ⅰ期25.2%(39/155),Ⅱ期78.8%(26/33),Ⅲ期90.7%(98/108),Ⅳ期100.0%(184/184),且盆腔粘连程度与内异症的临床期别间呈正相关关系(rs=0.870,P<0.01);(2)480例内异症患者中,伴痛经者占61.0%(293/480),其中轻、中、重度痛经分别为52.2%(153/293)、26.6%(78/293)、21.2%(62/293);伴CPP者占23.8%(114/480),伴性交痛者占15.4%(74/480),伴排便痛者占7.1%(34/480);(3)卵巢粘连与痛经和CPP呈正相关关系(rs=0.367、0.267,P<0.01);子宫底后壁粘连与痛经和CPP呈正相关关系(rs=0.336、0.164,P<0.01);输卵管粘连与痛经、CPP和排便痛均呈显著正相关关系(rs=0.283、0.225、0.159, P<0.01);直肠粘连与痛经呈正相关关系(rs=0.101,P<0.05).除性交痛外,内异症患者的盆腔粘连程度与其痛经、CPP及排便痛均呈正相关关系(rs=0.470、0.273、0.132、P<0.01).结论 盆腔粘连是内异症的特征性病变,粘连部位及程度与疼痛症状密切相关.     

Postoperative desogestrel for pelvic endometriosis-related pain: a randomized controlled trial

Objective: To determine the effectiveness of desogestrel for relieving endometriosis-related pain.

Methods: A double-blinded randomized placebo-controlled trial was conducted in 40 patients who had endometriosis with moderate-to-severe dysmenorrhea or chronic pelvic pain undergoing laparoscopic conservative surgery. After surgery, patients were randomized to desogestrel or placebo group. Outcomes included changes in visual analog scale (VAS) of dysmenorrhea, pelvic pain and dyspareunia, patient satisfaction, and adverse effects.

Results: Forty patients were randomized to desogestrel group (n?=?20) and placebo group (n?=?20). At month 6, the desogestrel group had significantly lower median VAS of overall pelvic pain, dysmenorrhea and noncyclic pelvic pain. Comparing with the placebo group, the desogestrel group had greater reduction in VAS of overall pain, dysmenorrhea and pelvic pain, but comparable reduction in VAS of dyspareunia. No patient in the desogestrel group but 4 patients in the placebo group still had moderate-to-severe pelvic pain at 6?months postoperatively. The proportion of patients who rated the treatment as very satisfied was higher in the desogestrel group than in the placebo group. There was no serious adverse event during the study period.

Conclusions: Desogestrel is effective and acceptable for postoperative therapy for patients with moderate-to-severe pain related to endometriosis.