Objective: To determine whether the initiation of estrogen replacement therapy (ERT) in the postoperative period increase the incidence of reoperative rate and symptomatic pelvic pain following laparoscopic hysterectomy (LH) and/without bilateral salpingo oophorectomy (BSO) for the treatment of endometriosis and adenomyosis. Design: Prospective partially randomized patient preference follow-up trial (PRPPT). Setting: Department of Gynaecology, Endoscopic Training Centra, Kladno Hospital, Czech Republic. Methods: Chart review of 286 consecutive patients who underwent LH and/or without BSO for endometriosis or adenomyosis between April 1994 and June 1999 and whom subsequently were proposed ERT 124 women with complete records were enrolled in the study and were randomized to ERT group and control group. Statistical analysis was performed using t-test when appropria- te, with a level of significance P = 0.05. Results: The women were followed for 24-87 month. Five (6.7%) patients of the ERT group experi- enced recurrent endometriosis after previous surgery compared five (10.3%) patients in the con- trol group. This difference in reoperation rate was statistical insignificant. Seven (9.7%) patients in the HRT group reported symptomatic pelvic pain compared with only one (2.04%) patient in the control group (P<0.001). In the HRT group, there were more adnexectomies (55 vs 19) perfor- med simoultaneously during primary surgery. In this study 8 cases out of 53 hysterectomies without BSO were found to development of endometriosis pathology: the reoperation rate was 18.9% (P<0.001). Conclusion: In the second phase of follow-up study was confirmed, that reoperation rate for endometriosis did not increase in group of laparoscopically hysterectomized women which were treated by ERT in the postoperative period. Results from the partially randomized trial demon- strate that ERT only increased significantly the number of patients with symptomatic pelvic pain.

        Key words: endometriosis, hormonal replacement therapy, laparoscopic hysterectomy