Pathologic, Laboratory, and Surgical Findings of Topical Statin Gels (Simvastatin, Atorvastatin, and Rosuvastatin) in a Rat Model of Peritoneal Endometriosis

Endometriosis is a chronic inflammatory disease with frequent recurrence. Statins, due to their anti-inflammatory and antioxidant properties, may help control disease progression, but comparative data on local administration are limited. We evaluated simvastatin-, atorvastatin-, and rosuvastatin-loaded lipophilic gels on lesions, adhesions, and inflammatory markers in a rat model of peritoneal endometriosis. Forty rats were randomized to statin gels (n = 10 each), chitosan gel (vehicle; n = 5), or no treatment (control; n = 5). Two weeks later, lesion size, adhesions, histopathology, and serum Interleukin-6 (IL-6) and Interleukin-1β (IL-1β) were assessed. All statins significantly reduced endometriotic lesion size compared with controls. Lesion volume decreased by approximately 97% with simvastatin, 88% with atorvastatin, and 72% with rosuvastatin, whereas lesion volume increased in the control and vehicle-treated groups. Adhesion severity was markedly reduced, with Hoffman scores decreasing from 7.2 ± 2.25 in controls to 1.9 ± 1.1 with simvastatin, compared with more modest reductions observed with atorvastatin and rosuvastatin. Similarly, Lauder adhesion scores were reduced by approximately 71% with simvastatin, confirming its superior anti-adhesion effect. Serum IL-6 and IL-1β levels were significantly decreased in all statin-treated groups, with no significant differences among statins. Overall, topical statin gel therapy effectively reduced lesion size, adhesions, and inflammation, with simvastatin showing superior anti-adhesion effects.