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


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 %).


CONCLUSIONS
12-month administration of hormonal therapies reduces the volume of rectovaginal endometriotic nodules infiltrating the rectum in the majority of cases.
Department of Obstetrics and Gynecology, National Institute for Cancer Research, San Martino Hospital, University of Genoa, Largo R. Benzi 1, 16132 Genoa, GE, Italy.
Simone
S
Ferrero
Umberto
U
Leone Roberti Maggiore
Carolina
C
Scala
Martina
M
Di Luca
Pier Luigi
PL
Venturini
Valentino
V
Remorgida
D000328:Adult; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use; D003279:Contraceptives, Oral, Sequential / Q000627:therapeutic use; D003280:Contraceptives, Oral, Synthetic / Q000627:therapeutic use; D017135:Desogestrel / Q000627:therapeutic use; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D000077289:Letrozole; D009570:Nitriles / Q000627:therapeutic use; D009640:Norethindrone / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077563:Norethindrone Acetate; D009652:Norpregnenes / Q000627:therapeutic use; D011446:Prospective Studies; D012002:Rectal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use; D017329:Triptorelin Pamoate / Q000627:therapeutic use; D014463:Ultrasonography; D014623:Vaginal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014815:Vitamins / Q000627:therapeutic use
D047072:Aromatase Inhibitors; D003279:Contraceptives, Oral, Sequential; D003280:Contraceptives, Oral, Synthetic; D020847:Estrogen Receptor Modulators; D009570:Nitriles; D009652:Norpregnenes; D014230:Triazoles; D014815:Vitamins; D017329:Triptorelin Pamoate; D002762:Cholecalciferol; D000077289:Letrozole; D017135:Desogestrel; D000077563:Norethindrone Acetate; C027385:tibolone; D002118:Calcium; D009640:Norethindrone