{
    "abstract": "To systematically review and conduct a meta-analysis to assess the effectiveness of dienogest (DNG) in the prolonged conservative drug management of deep infiltrating endometriosis (DIE). The findings from this study are intended to serve as a valuable reference for clinical decision-making regarding medication in the context of DIE.\nFollowing the PRISMA Statement, we searched EMBASE, PubMed, The Cochrane Library, Web of Science, and Medline databases for relevant literature published in the public domain from the date of establishment of the database until October 2023. Subsequently, all English publications on clinical studies using DNG for the treatment of DIE were included. Studies involving surgical intervention or drug therapy for postoperative recurrence were excluded. All literature included in the review underwent risk assessment of bias. Two evaluators independently screened the publications, conducted a quality assessment of each article and extracted data. We used Revman 5.4 for the meta-analysis of the included literature.\nOur final analysis consisted of five clinical studies, involving a total of 256 patients. We found that there were significant improvements in the following indicators post-medication as compared to levels before taking the medication: dysmenorrhea (MD\u00a0=\u00a04.24, 95\u00a0% CI: 2.92-5.56, P\u00a0<\u00a00.00001), non-menstrual pelvic pain (MD\u00a0=\u00a03.11, 95\u00a0% CI: 2.34-3.88, P\u00a0<\u00a00.00001), dyspareunia (MD\u00a0=\u00a01.93, 95\u00a0% CI: 1.50-2.37, P\u00a0<\u00a00.00001), dyschezia (MD\u00a0=\u00a02.48, 95\u00a0% CI: 1.83-3.12, P\u00a0<\u00a00.00001), and rectosigmoid nodule size (MD\u00a0=\u00a00.32, 95\u00a0% CI: 0.18-0.46, P\u00a0<\u00a00.00001). Compared with pre-medication levels, the following indicators were significantly worse: headache (RR\u00a0=\u00a00.03, 95\u00a0% CI: 0.00-0.23, P\u00a0=\u00a00.0006), decreased libido (RR\u00a0=\u00a00.08, 95\u00a0% CI: 0.01-0.62, P\u00a0=\u00a00.02); and there was no significant improvement in dysuria (P\u00a0>\u00a00.05).\nDNG showed efficacy in relieving pain-related symptoms and significantly reducing the size of the lesions when used in the drug conservative treatment of DIE.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China; Department of clinical medicine, Zunyi Medical And Pharmaceutical College, Zunyi 563000, Guizhou, China.",
            "firstname": "Han",
            "initials": "H",
            "lastname": "Wu"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China.",
            "firstname": "Jun-Jiang",
            "initials": "JJ",
            "lastname": "Liu"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China.",
            "firstname": "Sheng-Tou",
            "initials": "ST",
            "lastname": "Ye"
        },
        {
            "affiliation": "Department of Preventive Medicine, School of Public Health, Zunyi Medical University, Zunyi 563000, Guizhou, China.",
            "firstname": "Jun",
            "initials": "J",
            "lastname": "Liu"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China; Department of Obstetrics and Gynecology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China. Electronic address: foxlina2008@163.com.",
            "firstname": "Na",
            "initials": "N",
            "lastname": "Li"
        }
    ],
    "conclusions": "DNG showed efficacy in relieving pain-related symptoms and significantly reducing the size of the lesions when used in the drug conservative treatment of DIE.",
    "copyrights": "Copyright \u00a9 2024 Elsevier B.V. All rights reserved.",
    "doi": "10.1016/j.ejogrb.2024.03.032",
    "journal": "European journal of obstetrics, gynecology, and reproductive biology",
    "keywords": [
        "Deep infiltrating endometriosis",
        "Dienogest",
        "Dyspareunia",
        "Endometriosis",
        "Meta-analysis"
    ],
    "methods": null,
    "publication_date": "2024-04-06",
    "pubmed_id": "38579545",
    "results": "Our final analysis consisted of five clinical studies, involving a total of 256 patients. We found that there were significant improvements in the following indicators post-medication as compared to levels before taking the medication: dysmenorrhea (MD\u00a0=\u00a04.24, 95\u00a0% CI: 2.92-5.56, P\u00a0<\u00a00.00001), non-menstrual pelvic pain (MD\u00a0=\u00a03.11, 95\u00a0% CI: 2.34-3.88, P\u00a0<\u00a00.00001), dyspareunia (MD\u00a0=\u00a01.93, 95\u00a0% CI: 1.50-2.37, P\u00a0<\u00a00.00001), dyschezia (MD\u00a0=\u00a02.48, 95\u00a0% CI: 1.83-3.12, P\u00a0<\u00a00.00001), and rectosigmoid nodule size (MD\u00a0=\u00a00.32, 95\u00a0% CI: 0.18-0.46, P\u00a0<\u00a00.00001). Compared with pre-medication levels, the following indicators were significantly worse: headache (RR\u00a0=\u00a00.03, 95\u00a0% CI: 0.00-0.23, P\u00a0=\u00a00.0006), decreased libido (RR\u00a0=\u00a00.08, 95\u00a0% CI: 0.01-0.62, P\u00a0=\u00a00.02); and there was no significant improvement in dysuria (P\u00a0>\u00a00.05).",
    "title": "Efficacy and safety of dienogest in the treatment of deep infiltrating endometriosis: A meta-analysis.",
    "xml": "<Element 'PubmedArticle' at 0x788503b56ed0>"
}