Are gonadotropin-releasing hormone analogs and laparoscopic ablation equally effective treatments for endometriosis?

Abstract

Although both laparoscopic ablation and gonadotropin-releasing hormone analogs (GnRHa) are treatments for endometriosis, there are no studies that directly compare these two treatment options. METHODS: This study compares the use of GnRHa therapy and laparoscopic ablation concerning symptom relief, recurrence of symptoms, safety, side effects of treatment and improvement of quality of life in women ages 18-50 with diagnosed endometriosis. The study design is an evidence-based literature review, assessing each study for its research design, inclusion and exclusion criteria, treatment results, adverse affects and conclusions. RESULTS: All but one research study showed that GnRHa are effective at improving quality of life by relieving endometriosis symptoms up to one year post treatment. Side effects were consistent with hypoestrogenemia and were non-life threatening. Laparoscopic ablation was found to successfully treat endometriosis symptoms, but fertility rates were not consistently improved. Adhesion formation, infection and organ injury were complications of surgery, but were low in incidence. CONCLUSIONS: There are many factors that are necessary to consider when determining the most appropriate therapy. Both GnRHa and laparoscopic ablation are safe, reduce symptoms and improve the overall quality of life, therefore more research is needed in order to determine specific parameters for each treatment.