Background The aim of this study was to evaluate treatment with dienogest in women with deep infiltrating endometriosis (DIE). Methods A prospective cohort study was conducted at the Department of Gynecology and Obstetrics in the University of Campinas (UNICAMP), Brazil. The study included 16 women with DIE and pain which was not responsive to treatment with other progestins, who were treated with dienogest, and who attend a tertiary university hospital in 2013. Scores for pain complaints, quality of life, sexuality and extent of endometriotic lesions were evaluated before and 6 months after treatment. Statistical methods included the Wilcoxon matched-pairs test, which was used for the analysis of the quantitative data, and the relationship between them was tested by the Spearman correlation index. Results Women were a mean 36 ± 6.2 years old and reported onset of painful symptoms at a mean 29.9 ± 8.6 years of age. A significant reduction in dysmenorrhea, acyclic pelvic pain, dyspareunia and defecation pain was reported after treatment. There was no significant change in the assessment of quality of life or the Female Sexual Function Index. Intestinal lesions, which had an initial 3.4 ± 4.2 cc average size, decreased to 1.6 ± 1.8 cc, but this reduction was not statistically significant. The most common side effects were headaches and acne. Conclusions Dienogest can be used for clinical pain control in DIE.

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MELD is an important tool for allocation, resulting in a reduced waiting list, increased number of split-liver procedures, and use of ECDs without deterioration of survival times. DRI >1.7 was associated with shorter survival.