Hana Christy, T (2022) Efficacy of Various Medical Management of Ovarian Endometrioma: A Retrospective Observational study. Masters thesis, Christian Medical College, Vellore.
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Abstract
AIM OF THE STUDY: To assess the efficacy of various types of medical management of ovarian endometrioma and the need for change in management-medical or surgical, among women of reproductive age group 18 to 45 years who were treated in CMC Vellore gynecology OPD for at least 6 months. OBJECTIVES: To assess the efficacy of medical management in terms of regression of size of ovarian endometrioma retrospectively by viewing online OPD chart data from 2017 to 2019 over a period of 3 years among women of reproductive age group 18 to 45 years on medical management – extended cycle oral contraceptive pills or progestins for at least 6months in CMC Vellore gynaecology OPD. METHODS: Ours was a retrospective observational study to look for the efficacy of medical management and the need for change in management -medical or surgical, in terms of regression of size of ovarian endometrioma. Charts of 300 patients who consulted CMC Vellore Gynecology OPD from 2017 to 2019 and on medical management for ovarian endometrioma for at least 6 months were reviewed. This study was done as a chart review, on women in reproductive age group of 18 to 45years. These women were on a medical management for endometrioma for at least 6 months during the years 2017 to 2019. Most frequently used medical managements in our hospital for treatment of endometrioma were extended cycle OCP’s or progestins like Injection DMPA, Dienogest and Mirena. Following which recruitment of patients according to the inclusion and exclusion criteria was done. The total women selected in the study were 300. Through online charts of patients, the change in size of endometriomas and menstrual regulation were collected and analyzed. Size of endometrioma after the new treatment was noted following repeat ultrasound scan. The details were obtained from the online chart retrospectively. The efficacy of various medical managements on the endometrioma were compared from the time of starting medical management to after the change in management using Excel sheet. RESULTS: The efficacy of medical management in terms of decrease in size of endometrioma was slightly higher in extended cycle OCP group on comparison to inj. DMPA, dienogest and Mirena but statistically not proven. Thus, for a woman with endometrioma it is advisable to start with extended cycle OCP as first line management. Knowledge about breakthrough bleeding pattern has to be imparted to patients as it is commonest bleeding pattern noticed in patients on extended cycle OCPs. CONCLUSION: Extended cycle OCP has slightly higher efficacy in management of endometriosis but not proven statistically. There is need for change in medical and surgical management in patients with endometrioma mainly due to persisting symptoms of dysmenorrhea, non-cyclical abdominal pain, heavy menstrual blood loss and dyspareunia.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221916407 |
| Uncontrolled Keywords: | Efficacy, Medical Management, Ovarian Endometrioma, Retrospective Observational study. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology > MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 18 May 2021 16:27 |
| Last Modified: | 12 Sep 2023 02:33 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/17029 |
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