title: Continuous low-dose oral contraceptive in the treatment of colorectal endometriosis evaluated by rectal endoscopic ultrasonography.
abstract: OBJECTIVE
  Limited attention has been focused on the medical treatment of bowel endometriosis. This study evaluates the efficacy of administration of a continuous low-dose oral contraceptive in treating pain and other symptoms associated with colorectal endometriotic nodules, as evaluated by rectal endoscopic ultrasonography.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Academic Department of San Raffaele Scientific Institute, Obstetrics and Gynecology Unit.
  
  
  METHODS
  Symptomatic women of reproductive age (n=26) with colorectal nodules infiltrating at least the bowel muscularis propria and without a stenosis >50%. In 31% of the patients, endoscopic ultrasonography permitted diagnosis of nodules located more than 10 cm from the anal rim.
  
  
  METHODS
  Patients received a continuous low-dose oral contraceptive containing 15 μg ethinylestradiol and 60 μg gestodene for 12 months. Subjective symptoms were prospectively evaluated, and nodule volumes were monitored using endoscopic ultrasonography.
  
  
  METHODS
  Nodule measurements were performed at baseline and after 12 months of treatment. Symptoms at the start and after 12 months were evaluated.
  
  
  RESULTS
  A significant improvement in the intensity of all the considered symptoms (dysmenorrhea, non-menstrual pelvic pain, deep dyspareunia and painful defecation) was seen when evaluated by a visual analog scale. A reduction in terms of both diameter (mean reduction 26%) and volume of the nodules (mean reduction 62%) was observed after a 12 month period.
  
  
  CONCLUSIONS
  A continuous low-dose oral contraceptive therapy may reduce bowel endometriosis-associated symptoms. In addition, this therapy induces a significant volumetric reduction of colorectal plaques when evaluated by endoscopic ultrasonography.
authors.affiliation: Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy. ferrari.stefano@hsr.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
authors.forename: Paola
authors.initials: P
authors.lastname: Persico
authors.forename: Francesca
authors.initials: F
authors.lastname: DI Puppo
authors.forename: Paola
authors.initials: P
authors.lastname: Vigano
authors.forename: Iacopo
authors.initials: I
authors.lastname: Tandoi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Garavaglia
authors.forename: Paolo
authors.initials: P
authors.lastname: Giardina
authors.forename: Gianni
authors.initials: G
authors.lastname: Mezzi
authors.forename: Massimo
authors.initials: M
authors.lastname: Candiani
mesh_terms: D000328:Adult; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004412:Dysmenorrhea / Q000209:etiology / Q000628:therapy; D004414:Dyspareunia / Q000209:etiology / Q000628:therapy; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D019160:Endosonography; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D009652:Norpregnenes / Q000008:administration & dosage; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D012002:Rectal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*
chemical_list: D003280:Contraceptives, Oral, Synthetic; D004338:Drug Combinations; D009652:Norpregnenes; C033273:Gestodene; D004997:Ethinyl Estradiol