title: Desogestrel-only contraceptive pill versus sequential contraceptive vaginal ring in the treatment of rectovaginal endometriosis infiltrating the rectum: a prospective open-label comparative study.
abstract: OBJECTIVE
  To compare the efficacy of two hormonal therapies in treating symptoms caused by bowel endometriosis.
  
  
  METHODS
  Patient preference study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A total of 143 women with rectovaginal endometriosis infiltrating the rectum.
  
  
  METHODS
  This study was performed between January 2008 and June 2011. Patients were treated with a desogestrel-only contraceptive pill or with the sequential combined contraceptive vaginal ring for 12 months.
  
  
  METHODS
  The primary endpoint of the study was the rate of satisfied patients at 12-month follow up. The changes in symptoms and in the volume of the nodules were secondary endpoints.
  
  
  RESULTS
  At 12-month follow up, the rate of satisfied patients was higher in the group treated with the desogestrel-only contraceptive pill than in the group treated with the sequential combined contraceptive vaginal ring (p = 0.004). When only changes in gastrointestinal symptoms were considered, 50% of patients treated with the desogestrel-only contraceptive pill and 31.3% of those treated with the sequential combined contraceptive vaginal ring were satisfied (p = 0.037). The reduction in the volume of the nodules, the percentages of patients who discontinued the therapy after the completion of the study and of those who decided to undergo surgery were similar between the two groups.
  
  
  CONCLUSIONS
  Both hormonal therapies are efficacious in treating symptoms caused by rectovaginal endometriosis infiltrating the rectum. Patient satisfaction is higher with the desogestrel-only pill than with a vaginal ring.
authors.affiliation: Department of Obstetrics and Gynecology, San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Leone Roberti Maggiore
authors.forename: Valentino
authors.initials: V
authors.lastname: Remorgida
authors.forename: Carolina
authors.initials: C
authors.lastname: Scala
authors.forename: Emanuela
authors.initials: E
authors.lastname: Tafi
authors.forename: Pier L
authors.initials: PL
authors.lastname: Venturini
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
mesh_terms: D000328:Adult; D003274:Contraceptive Devices, Female; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage* / Q000009:adverse effects; D017135:Desogestrel / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D004338:Drug Combinations; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D004997:Ethinyl Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017060:Patient Satisfaction; D011446:Prospective Studies; D012002:Rectal Diseases / Q000188:drug therapy / Q000209:etiology*
chemical_list: D003280:Contraceptives, Oral, Synthetic; D004338:Drug Combinations; C516519:NuvaRing; D004997:Ethinyl Estradiol; D017135:Desogestrel
keywords: Bowel endometriosis; desogestrel; endometriosis; hormonal therapy; vaginal ring