ABSTRACT
Following identification of the proportion of pelvic congestion among symptomatic patients complaining of chronic pelvic pain, and in a totally asymptomatic group of patients requesting tubal ligation, the efficiency of goserelin acetate versus medroxyprogesterone acetate was compared objectively using pelvic venogram scores, and subjectively by symptom resolution, improvement of psychological status and sexual functioning in a prospective randomized trial in 47 patients with pure pelvic congestion syndrome. Patients received either goserelin acetate (3.6 mg/month for 6 months) or medroxyprogesterone acetate (MPA; 30 mg/day for 6 months). Among patients with chronic pelvic pain, those with pure pelvic congestion were mostly parous, had the most severe pelvic signs and symptom scores, lowest rates of sexual functioning, and higher states of anxiety and depression as compared with others. At 1 year after treatment, goserelin remained superior to MPA in terms of pelvic venographic improvement as an objective measure. In alleviation of signs and symptomatology, improvement of sexual functioning and reduction of anxiety and depressive states as subjective measures, goserelin acetate achieved a statistically significant advantage (P = 0.0001) compared with MPA.
Subject(s)
Adnexal Diseases/drug therapy , Goserelin/therapeutic use , Medroxyprogesterone Acetate/therapeutic use , Adnexal Diseases/complications , Adnexal Diseases/psychology , Anxiety , Chronic Disease , Depression , Female , Humans , Pelvic Pain , Pelvis/blood supply , Phlebography , Prospective Studies , Sexual Dysfunction, Physiological/etiology , Sexual Dysfunction, Physiological/therapyABSTRACT
A complex of nonpharmaceutical analgetic modalities has been tried in 25 females with internal endometriosis. Each component of the program has a pronounced analgetic action and participates in formation of somatic, vegetative and emotional responses. Aftertreatment pain characteristics proved the complex efficacy in mild, moderate and advanced internal endometriosis. It is emphasized that the patients can be taught to use the complex without help of medical personnel.
