Changes in the size of rectovaginal endometriotic nodules infiltrating the rectum during hormonal therapies

Arch Gynecol Obstet. 2013 Mar;287(3):447-53. doi: 10.1007/s00404-012-2581-2. Epub 2012 Oct 9.

Abstract

Purpose: To evaluate the changes in the volume of rectovaginal endometriotic nodules infiltrating the rectum during 12-month treatment with hormonal therapies.

Materials and methods: This prospective, non-randomized, self-controlled clinical trial included patients with rectovaginal endometriotic nodules infiltrating at least the muscularis propria of the rectum, who received one of the following therapies: norethisterone acetate, triptorelin and tibolone, norethisterone acetate and letrozole, desogestrel, sequential oral contraceptive pill. The volume of the nodules was determined by virtual organ computer-aided analysis (VOCAL, GE Healthcare, USA) at baseline and after 6 and 12 months of treatment.

Results: Eighty-three women (90.2 %) completed the 12-month treatment. When compared with baseline values, the volume of the nodules decreased at 6-month (p < 0.001) and 12-month treatment (p < 0.001). After 12-month treatment, the volume of the nodules decreased in all study groups. The volume of the nodules decreased during therapy in 68 women (73.9 %) and increased in 11 women (12.0 %).

Conclusion: 12-month administration of hormonal therapies reduces the volume of rectovaginal endometriotic nodules infiltrating the rectum in the majority of cases.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aromatase Inhibitors / therapeutic use
  • Calcium / therapeutic use
  • Cholecalciferol / therapeutic use
  • Contraceptives, Oral, Sequential / therapeutic use
  • Contraceptives, Oral, Synthetic / therapeutic use
  • Desogestrel / therapeutic use
  • Endometriosis / diagnostic imaging
  • Endometriosis / drug therapy*
  • Estrogen Receptor Modulators / therapeutic use
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Letrozole
  • Nitriles / therapeutic use
  • Norethindrone / analogs & derivatives
  • Norethindrone / therapeutic use
  • Norethindrone Acetate
  • Norpregnenes / therapeutic use
  • Prospective Studies
  • Rectal Diseases / diagnostic imaging
  • Rectal Diseases / drug therapy*
  • Treatment Outcome
  • Triazoles / therapeutic use
  • Triptorelin Pamoate / therapeutic use
  • Ultrasonography
  • Vaginal Diseases / diagnostic imaging
  • Vaginal Diseases / drug therapy*
  • Vitamins / therapeutic use

Substances

  • Aromatase Inhibitors
  • Contraceptives, Oral, Sequential
  • Contraceptives, Oral, Synthetic
  • Estrogen Receptor Modulators
  • Nitriles
  • Norpregnenes
  • Triazoles
  • Vitamins
  • Triptorelin Pamoate
  • Cholecalciferol
  • Letrozole
  • Desogestrel
  • Norethindrone Acetate
  • tibolone
  • Calcium
  • Norethindrone