Conservative treatment of rectosigmoid endometriosis: A prospective study

Anne G. Egekvist*, Edvard Marinovskij, Axel Forman, Ulrik S. Kesmodel, Ole Graumann, Mikkel Seyer-Hansen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Introduction: Deep infiltrating endometriosis is a common cause of pelvic pain. However, some patients have limited problems that may be controlled by medical treatment, so avoiding the potentially severe complications of major surgery. This approach requires detailed knowledge on quality of life and clinical symptoms over time. The aim of the study was to monitor these parameters in patients with rectosigmoid endometriosis treated with oral contraceptives, oral gestagens, and/or the levonorgestrel-releasing intrauterine device. Moreover, nodule size measurements performed with transvaginal sonography were correlated to severity of symptoms. Material and methods: Conservatively treated patients on oral contraceptives, oral gestagens, or the levonorgestrel-releasing intrauterine device underwent transvaginal sonography and answered a self-administered questionnaire regarding clinical symptoms and quality of life (Short Form 36 and Endometriosis Health Profile 30) at baseline, and 6 and 12 months later. Results: Eighty women completed the follow up. Scores of quality of life were comparable to normative data for Danish women of similar age and did not change with time. No association between change in size of the rectosigmoid nodule and change in symptoms was seen. Conclusions: This study supports that simple treatment with oral contraceptives, oral gestagens, or the levonorgestrel-releasing intrauterine device represents a viable therapeutic approach to rectosigmoid Deep infiltrating endometriosis, provided that proper selection of patients in need of surgery exists.

Original languageEnglish
JournalActa Obstetricia et Gynecologica Scandinavica
Volume98
Issue number9
Pages (from-to)1139-1147
ISSN0001-6349
DOIs
Publication statusPublished - Sep 2019

Fingerprint

Endometriosis
Levonorgestrel
Intrauterine Devices
Progestins
Oral Contraceptives
Prospective Studies
Quality of Life
Ultrasonography
Patient Selection
Conservative Treatment
Health

Keywords

  • bowel endometriosis
  • deep infiltrating endometriosis
  • dysmenorrhea
  • endometriosis
  • medical therapy
  • oral contraceptives
  • pelvic pain
  • progestins

Cite this

Egekvist, A. G., Marinovskij, E., Forman, A., Kesmodel, U. S., Graumann, O., & Seyer-Hansen, M. (2019). Conservative treatment of rectosigmoid endometriosis: A prospective study. Acta Obstetricia et Gynecologica Scandinavica, 98(9), 1139-1147. https://doi.org/10.1111/aogs.13619
Egekvist, Anne G. ; Marinovskij, Edvard ; Forman, Axel ; Kesmodel, Ulrik S. ; Graumann, Ole ; Seyer-Hansen, Mikkel. / Conservative treatment of rectosigmoid endometriosis : A prospective study. In: Acta Obstetricia et Gynecologica Scandinavica. 2019 ; Vol. 98, No. 9. pp. 1139-1147.
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Egekvist, AG, Marinovskij, E, Forman, A, Kesmodel, US, Graumann, O & Seyer-Hansen, M 2019, 'Conservative treatment of rectosigmoid endometriosis: A prospective study', Acta Obstetricia et Gynecologica Scandinavica, vol. 98, no. 9, pp. 1139-1147. https://doi.org/10.1111/aogs.13619

Conservative treatment of rectosigmoid endometriosis : A prospective study. / Egekvist, Anne G.; Marinovskij, Edvard; Forman, Axel; Kesmodel, Ulrik S.; Graumann, Ole; Seyer-Hansen, Mikkel.

In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 98, No. 9, 09.2019, p. 1139-1147.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Conservative treatment of rectosigmoid endometriosis

T2 - A prospective study

AU - Egekvist, Anne G.

AU - Marinovskij, Edvard

AU - Forman, Axel

AU - Kesmodel, Ulrik S.

AU - Graumann, Ole

AU - Seyer-Hansen, Mikkel

PY - 2019/9

Y1 - 2019/9

N2 - Introduction: Deep infiltrating endometriosis is a common cause of pelvic pain. However, some patients have limited problems that may be controlled by medical treatment, so avoiding the potentially severe complications of major surgery. This approach requires detailed knowledge on quality of life and clinical symptoms over time. The aim of the study was to monitor these parameters in patients with rectosigmoid endometriosis treated with oral contraceptives, oral gestagens, and/or the levonorgestrel-releasing intrauterine device. Moreover, nodule size measurements performed with transvaginal sonography were correlated to severity of symptoms. Material and methods: Conservatively treated patients on oral contraceptives, oral gestagens, or the levonorgestrel-releasing intrauterine device underwent transvaginal sonography and answered a self-administered questionnaire regarding clinical symptoms and quality of life (Short Form 36 and Endometriosis Health Profile 30) at baseline, and 6 and 12 months later. Results: Eighty women completed the follow up. Scores of quality of life were comparable to normative data for Danish women of similar age and did not change with time. No association between change in size of the rectosigmoid nodule and change in symptoms was seen. Conclusions: This study supports that simple treatment with oral contraceptives, oral gestagens, or the levonorgestrel-releasing intrauterine device represents a viable therapeutic approach to rectosigmoid Deep infiltrating endometriosis, provided that proper selection of patients in need of surgery exists.

AB - Introduction: Deep infiltrating endometriosis is a common cause of pelvic pain. However, some patients have limited problems that may be controlled by medical treatment, so avoiding the potentially severe complications of major surgery. This approach requires detailed knowledge on quality of life and clinical symptoms over time. The aim of the study was to monitor these parameters in patients with rectosigmoid endometriosis treated with oral contraceptives, oral gestagens, and/or the levonorgestrel-releasing intrauterine device. Moreover, nodule size measurements performed with transvaginal sonography were correlated to severity of symptoms. Material and methods: Conservatively treated patients on oral contraceptives, oral gestagens, or the levonorgestrel-releasing intrauterine device underwent transvaginal sonography and answered a self-administered questionnaire regarding clinical symptoms and quality of life (Short Form 36 and Endometriosis Health Profile 30) at baseline, and 6 and 12 months later. Results: Eighty women completed the follow up. Scores of quality of life were comparable to normative data for Danish women of similar age and did not change with time. No association between change in size of the rectosigmoid nodule and change in symptoms was seen. Conclusions: This study supports that simple treatment with oral contraceptives, oral gestagens, or the levonorgestrel-releasing intrauterine device represents a viable therapeutic approach to rectosigmoid Deep infiltrating endometriosis, provided that proper selection of patients in need of surgery exists.

KW - bowel endometriosis

KW - deep infiltrating endometriosis

KW - dysmenorrhea

KW - endometriosis

KW - medical therapy

KW - oral contraceptives

KW - pelvic pain

KW - progestins

U2 - 10.1111/aogs.13619

DO - 10.1111/aogs.13619

M3 - Journal article

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AN - SCOPUS:85065547948

VL - 98

SP - 1139

EP - 1147

JO - Acta Obstetricia et Gynecologica Scandinavica

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