Treatment of symptomatic rectovaginal endometriosis with an estrogen–progestogen combination versus low-dose norethindrone acetate

Vercellini, Paolo; Pietropaolo, Giuliana; Giorgi, Olga De; Pasin, Roberta; Chiodini, Annalisa; Crosignani, Pier Giorgio

doi:10.1016/j.fertnstert.2005.03.083

Cited by 178 publications

(143 citation statements)

References 21 publications

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“…Although medical treatment may be effective in some DIE patients (Fedele et al, 2001;Vercellini et al, 2005), the treatment of choice is surgical excision (Garry, 1997). The multifocal nature of DIE lesionsa major characteristic of this form of endometriosis-must be taken into account when defining the surgical strategy (Chapron et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Surgery for bladder endometriosis: long-term results and concomitant management of associated posterior deep lesions

et al. 2010

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background: Deep infiltrating endometriosis (DIE) is presented as a disease with high recurrence risk. Bladder DIE is the most frequent location in cases of urinary endometriosis. Surgical removal has been recommended for bladder DIE but long-term outcomes remains unevaluated. The objectives of this study are to evaluate the rate of recurrence after partial cystectomy for patients presenting with bladder DIE and to outline the surgical modalities for handling associated posterior DIE nodules.methods: Seventy-five consecutive patients with histologically proved bladder DIE were enrolled at a single tertiary academic center between June 1992 and December 2007. A partial cystectomy was performed for each patient. Complete surgical exeresis of all associated symptomatic DIE lesions was carried out during the same surgical procedure. Bladder DIE patients were classified into three groups: patients with isolated bladder DIE (Group A); patients with associated symptomatic posterior DIE (Group B); patients with associated asymptomatic posterior DIE (Group C). Bladder DIE recurrence was defined as a clinical reappearance of the disease or radiological evidence that mandated a new surgical procedure. We assessed pelvic pain symptoms pre-and post-operatively using a 10-cm visual analogue scale.results: In a series of 627 patients with DIE, we observed 75 patients (12%) with bladder DIE. With a 50.9 + 44.6 months mean followup after partial cystectomy no patient presented evidence of bladder DIE recurrence. Post-operatively, we observed a significant improvement with respect to pain symptoms, with only two patients (2.7%) developing major complications during follow-up. Among patients with non-operated associated asymptomatic posterior DIE lesions (n ¼ 15), a second surgical procedure indicated for pain symptoms was necessary in only one patient (6.7%).conclusions: For patients presenting with bladder DIE, no patients required further surgery for bladder recurrence after radical surgery consisting in partial cystectomy. Exeresis of associated posterior DIE nodules is indicated only when they are symptomatic.

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Section: Introductionmentioning

confidence: 99%

Surgery for bladder endometriosis: long-term results and concomitant management of associated posterior deep lesions

et al. 2010

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“…For example, in a randomised controlled trial of daily norethisterone acetate, 2.5 mg, Vercellini et al 9 found good pain relief, with efficacy comparable with that of surgery. Although women did not have to endure surgical complications and did not report any significant long-term bowel morbidity, around one-quarter of women disliked the side effects of progesterone therapy, particularly the mean weight gain of 2.3 kg, and other systemic effects, such as a decrease in libido.…”

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confidence: 99%

The surgical management of rectovaginal endometriosis: plus ça change?

Wright

Ballard

2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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“…As DIE nodules are generally rich in nerve fibers [12], patients with DIE suffered from severe pelvic pain, such as dysmenorrhea and deep dyspareunia [13]- [15]. The medical therapies may temporally alleviate painful symptoms, however recurrence rates after the discontinuation are reported to be high [4] [16]. Thus, radical surgical excisions for DIE lesion are thought to be the mainstay of the treatment for this type of endometriosis.…”

Section: Discussionmentioning

confidence: 99%

Case Report: A Laparoscopic Treated Case of Deep Infiltrating Endometriosis with Vaginal Invasion Diagnosed by Vaginal Cytology

Niwa¹,

Yano²,

Hatanaka³

et al. 2015

OJPathology

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A recently observed case of deep infiltrating endometriosis with its vaginal invasion diagnosed by vaginal cytology is reported. A 28-year-old Japanese woman complained of a severe dysmenorrhea. Left ovarian endometriotic cyst and deep infiltrating endometriosis were suspected. Two redspots were also present in the posterior fornix of vagina. Vaginal cytology with cytokeratin (CK) 7-immunocytochemistry suggested the presence of infiltrating endometriosis. She underwent left ovarian cystectomy and resection of thickened uterosacral ligaments with vaginal endometriotic spots, under a laparoscope, based on the diagnosis of endometriotic cyst. Histopathology revealed DIE with vaginal invasion. Immunostaining for CK7 was positive for endometriotic cyst, while CK20 was negative. The stromal cells in endometriosis were immunohistochemically positive for CD10. The vaginal fornix was well-healed one month later the surgery. Postoperatively, she got pregnant with her natural intercourse and delivered a healthy 2138 g girl at 36 weeks of gestation.

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Treatment of symptomatic rectovaginal endometriosis with an estrogen–progestogen combination versus low-dose norethindrone acetate

Cited by 178 publications

References 21 publications

Surgery for bladder endometriosis: long-term results and concomitant management of associated posterior deep lesions

Surgery for bladder endometriosis: long-term results and concomitant management of associated posterior deep lesions

The surgical management of rectovaginal endometriosis: plus ça change?

Case Report: A Laparoscopic Treated Case of Deep Infiltrating Endometriosis with Vaginal Invasion Diagnosed by Vaginal Cytology

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