Treatment of rectovaginal endometriosis with the etonogestrel-releasing contraceptive implant

Abstract

This study aimed to investigate the efficacy of the etonogestrel (ENG)-releasing implant in treating patients with rectovaginal endometriosis. The study was based on the retrospective analysis of a prospectively collected database, including symptomatic women who had ultrasonographic diagnosis of rectovaginal endometriosis. Patients were follow-up at 6, 12 and 24 months from the insertion of the ENG-releasing implant. The intensity of pain symptoms was evaluated using a visual analog scale. The volume of the nodules was estimated by virtual organ computer-aided analysis. The Endometriosis Health Profile (EHP-30) was used to evaluate quality of life. Overall, 43 women were included in the study. The 2-year continuation rate for the ENG-releasing implant was 93.0%. The treatment quickly improved the intensity of non-menstrual pelvic pain, deep dyspareunia, dysmenorrhea, and dyschezia. At 6-month follow-up, there were improvements in all domains of the EHP-30 compared with baseline. Further improvements in the EHP-30 results were observed only in pain sub score at 12-month follow-up and in emotional well-being sub score at 24-month follow-up. At 6-month follow-up the volume of the rectovaginal nodules was significantly lower compared with baseline; a further decrease was observed at 12- and 24-month follow-up. The treatment was well tolerated.

摘要

本研究旨在探讨依托诺孕酮释放植入物治疗直肠阴道子宫内膜异位症的疗效。这项研究是基于对一个前瞻性收集的数据库的回顾性分析, 其中包括有直肠阴道子宫内膜异位症超声诊断症状的妇女。ENG释放植入物植入后的6、12和24个月对患者进行随访, 用视觉模拟量表评估疼痛症状的强度, 用虚拟器官计算机辅助分析法估计结节体积, 应用子宫内膜异位症健康档案（EHP-30）评价患者的生活质量。总共有43名妇女参加了这项研究, ENG缓释植入物的2年持续率为93.0%。这种疗法很快改善了非月经性盆腔疼痛、深度性交不适、痛经和排尿困难的程度。在6个月的随访中, 与基线相比, EHP-30的所有领域都有改善； 仅在12个月的随访中疼痛亚评分和24个月的随访中情绪健康亚评分中观察到EHP-30结果的进一步改善。在6个月的随访中, 直肠阴道结节的体积明显低于基线水平；在12个月和24个月的随访中观察到结节体积进一步减小, 治疗耐受性良好。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Endometriosis
• etonogestrel implant
• progestin
• rectovaginal septum
• treatment

Disclosure statement

No potential conflict of interest was reported by the authors.