Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2024; 12(21): 4601-4608
Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4601
Effect of dienogest treatment on uterine fibroid volume in patients with endometriosis or adenomyosis complicated by uterine fibroids
De-Yu Zhang, Yan Huang, Chao Peng, Ying-Fang Zhou
De-Yu Zhang, Yan Huang, Chao Peng, Ying-Fang Zhou, Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
Co-first authors: De-Yu Zhang and Yan Huang.
Co-corresponding authors: Chao Peng and Ying-Fang Zhou.
Author contributions: Zhou YF and Peng C contributed in manuscript editing and designed the research; Zhang DY and Yan Huang contributed in data collection, interpretation of data and manuscript writing/editing, both authors have made vital and indispensable contributions to the completion of the project and are therefore qualified to be co-first authors of the paper. As co-corresponding authors, Zhou YF and Peng C played an important and indispensable role in project design, data interpretation, and manuscript preparation. Zhou YF conceptualized, designed, and supervised the whole process of the project. He searched the literature, revised and submitted the early version of the manuscript with the focus on the effects of treatment with dienogest on uterine fibroid size in patients with endometriosis or adenomyosis. Peng C suggested that the volume changes of adenomyoma and cysts during treatment should be analyzed simultaneously, the related factors affecting the volume changes of uterine fibroids should be explored. Her also was responsible for figure plotting, comprehensive literature search, preparation and submission of the current version. Peng C applied for and obtained the funds for this research project. This collaboration between Zhou YF and Peng C is crucial for the publication of this manuscript and other manuscripts still in preparation. All authors have read and approved the final manuscript.
Supported by the National Key R&D Program of Reproductive Health and Women's and Children's Health Assurance Special Fund, No. 2022YFC2704004.
Institutional review board statement: All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki,and the protocol was approved by the Ethics Committee of Peking University First Hospital. Ethical approval code: [2022 Research 510].
Informed consent statement: The requirement for informed consent to review medical records and images was waived because this was a retrospective study. The presented data are anonymized and risk of identification is low.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Fang Zhou, PhD, Chief Doctor, Full Professor, Postdoctoral Fellow, Department of Obstetrics and Gynecology, Peking University First Hospital, No. 1 Xi'anmen Street, Xicheng District, Beijing, People’s Republic of China, Beijing 100034, China. zhouyf8853@163.com
Received: April 29, 2024
Revised: May 26, 2024
Accepted: June 7, 2024
Published online: July 26, 2024
Processing time: 63 Days and 10.5 Hours
Abstract
BACKGROUND

Currently, the use of dienogest in clinical practice has increased significantly, and many studies have focused on its effectiveness and safety in the treatment of endometriosis and adenomyosis; however, the effects of treatment with dienogest on uterine fibroid size in patients with endometriosis or adenomyosis have not been investigated.

AIM

To explore changes in fibroid size in patients with concomitant uterine fibroids undergoing dienogest treatment for endometriosis or adenomyosis and to evaluate the effectiveness and safety of the drug.

METHODS

The clinical data of patients with uterine fibroids treated with dienogest for endometriosis or adenomyosis at Peking University First Hospital from January 2021 to January 2023 were retrospectively analyzed.

RESULTS

The maximum uterine fibroid diameter and volume increased after 3 months, 6 months and 1 year of dienogest treatment compared with those before treatment (P < 0.01). The maximum diameter and volume of the uterine adenomyoma increased after 3 months of dienogest treatment but decreased after 6 months and 1 year of treatment compared with those before treatment, but the difference was not significant (P > 0.05). Endometrial thickness and antigen 125 levels were significantly thinner and decreased, respectively, after dienogest treatment (P < 0.01). Pearson's correlation analysis revealed that the increase in uterine fibroid volume after 3 months of dienogest treatment was positively correlated with the basic uterine fibroid volume (r = 0.792, P < 0.01). Among 64 patients with dysmenorrhea, 63 experienced significant relief of dysmenorrhea after 6 months of treatment with dienogest, and all patients experienced significant relief of dysmenorrhea after 12 months. Patients were able to tolerate the drugs, with an average drug tolerance score of 8.73.

CONCLUSION

The use of dienogest in patients with endometriosis or adenomyosis combined with uterine fibroids can effectively relieve the patient's pain symptoms and significantly reduce the sizes of ovarian endometriotic cysts, but it cannot inhibit uterine fibroid growth.

Keywords: Dienogest; Uterine fibroids; Endometriosis; Adenomyosis; Long-term postoperative management

Core Tip: This is a retrospective single-center observational study. The clinical data of patients with endometriosis or adenomyosis with concomitant uterine fibroids during treatment with dienogest were summarizes, and the effectiveness and safety of the drug were evaluated. The use of dienogest in patients with endometriosis or adenomyosis with concomitant uterine fibroids can effectively relieve the patient's pain symptoms and significantly reduce the sizes of ovarian endometriosis cysts, but it cannot inhibit uterine fibroid growth.