Cochrane · systematic review · CD003678

Pre‐ and postsurgical medical therapy for endometriosis surgery

Chen, I, Veth, VB, Choudhry, AJ, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Gynaecology and Fertility2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
18
current version
GRADE rated
13
No studies
5
Included studies
NR
No studies 5 · 27.8%Ungraded 0 · 0%Very low 9 · 50%Low 3 · 16.7%Moderate 1 · 5.6%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Presurgical medical therapy compared with placebo or no medical therapy

Population: women having endometriosis surgery
6 questions
OutcomeEffectEvidenceStatus / GRADE
Pain (continuous) Pelvic pain ≤ 12 months
Presurgical medical therapy vs placebo or no medical therapy
no estimate extractedNRNo studies
Pain recurrence (dichotomous) Pain recurrence ≤ 12 months
Presurgical medical therapy vs placebo or no medical therapy
RR 1.1 [0.72, 1.66]1 study · 262 participantsVery low
Downgraded: risk of bias, imprecision
Disease recurrence at 3 months – total (AFS score)
Presurgical medical therapy vs placebo or no medical therapy
no estimate extracted1 study · 80 participantsVery low
Downgraded: risk of bias, imprecision
Disease recurrence ≤ 12 months (dichotomous)
Presurgical medical therapy vs placebo or no medical therapy
no estimate extractedNRNo studies
Disease recurrence ≤ 12 months (EEC stage)
Presurgical medical therapy vs placebo or no medical therapy
RR 1.11 [0.86, 1.43]1 study · 262 participantsVery low
Downgraded: risk of bias, imprecision
Pregnancy rate (dichotomous)
Presurgical medical therapy vs placebo or no medical therapy
RR 1.18 [0.97, 1.45]1 study · 262 participantsVery low
Downgraded: risk of bias, imprecision

Postsurgical medical therapy compared with placebo or no medical therapy

Population: women having endometriosis surgery
6 questions
OutcomeEffectEvidenceStatus / GRADE
Pain (continuous) Pelvic pain ≤ 12 months
Postsurgical medical therapy vs placebo or no medical therapy
no estimate extracted3 studies · 340 participantsVery low
Downgraded: risk of bias, inconsistency
Pain recurrence (dichotomous) Pain recurrence ≤ 12 months
Postsurgical medical therapy vs placebo or no medical therapy
RR 0.7 [0.52, 0.94]5 studies · 657 participantsLow
Downgraded: risk of bias, imprecision
Disease recurrence at 12 months – total (AFS score)
Postsurgical medical therapy vs placebo or no medical therapy
no estimate extracted1 study · 53 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Disease recurrence ≤ 12 months (dichotomous)
Postsurgical medical therapy vs placebo or no medical therapy
RR 0.3 [0.17, 0.54]4 studies · 433 participantsLow
Downgraded: risk of bias
Disease recurrence ≤ 12 months (EEC stage)
Postsurgical medical therapy vs placebo or no medical therapy
RR 0.88 [0.67, 1.15]1 study · 285 participantsVery low
Downgraded: risk of bias
Pregnancy rate (dichotomous)
Postsurgical medical therapy vs placebo or no medical therapy
RR 1.19 [1.02, 1.38]11 studies · 955 participantsModerate
Downgraded: risk of bias

Presurgical medical therapy compared with postsurgical medical therapy

Population: women having endometriosis surgery
6 questions
OutcomeEffectEvidenceStatus / GRADE
Pain (continuous) Pelvic pain ≤ 12 months
Presurgical medical therapy vs postsurgical medical therapy
no estimate extractedNRNo studies
Pain recurrence (dichotomous) Pain recurrence ≤ 12 months
Presurgical medical therapy vs postsurgical medical therapy
RR 1.4 [0.95, 2.07]2 studies · 326 participantsLow
Downgraded: risk of bias, imprecision
Disease recurrence at 12 months –total (AFS score)
Presurgical medical therapy vs postsurgical medical therapy
no estimate extractedNRNo studies
Disease recurrence ≤ 12 months (dichotomous)
Presurgical medical therapy vs postsurgical medical therapy
no estimate extractedNRNo studies
Disease recurrence ≤ 12 months (EEC stage)
Presurgical medical therapy vs postsurgical medical therapy
RR 1.26 [0.97, 1.65]1 study · 273 participantsVery low
Downgraded: risk of bias, imprecision
Pregnancy rate (dichotomous)
Presurgical medical therapy vs postsurgical medical therapy
RR 1.08 [0.9, 1.3]1 study · 273 participantsVery low
Downgraded: risk of bias, imprecision