Continuous low‐dose oral contraceptive in the treatment of colorectal endometriosis evaluated by rectal endoscopic ultrasonography
Open accessAbstract
Objective. Limited attention has been focused on the medical treatment of bowel endometriosis. This study evaluates the efficacy of administration of a continuous low‐dose oral contraceptive in treating pain and other symptoms associated with colorectal endometriotic nodules, as evaluated by rectal endoscopic ultrasonography. Design. Prospective observational study. Setting. Academic Department of San Raffaele Scientific Institute, Obstetrics and Gynecology Unit. Population. Symptomatic women of reproductive age (n=26) with colorectal nodules infiltrating at least the bowel muscularis propria and without a stenosis >50%. In 31% of the patients, endoscopic ultrasonography permitted diagnosis of nodules located more than 10 cm from the anal rim. Methods. Patients received a continuous low‐dose oral contraceptive containing 15 μg ethinylestradiol and 60 μg gestodene for 12 months. Subjective symptoms were prospectively evaluated, and nodule volumes were monitored using endoscopic ultrasonography. Main outcome measures. Nodule measurements were performed at baseline and after 12 months of treatment. Symptoms at the start and after 12 months were evaluated. Results. A significant improvement in the intensity of all the considered symptoms (dysmenorrhea, non‐menstrual pelvic pain, deep dyspareunia and painful defecation) was seen when evaluated by a visual analog scale. A reduction in terms of both diameter (mean reduction 26%) and volume of the nodules (mean reduction 62%) was observed after a 12 month period. Conclusions. A continuous low‐dose oral contraceptive therapy may reduce bowel endometriosis‐associated symptoms. In addition, this therapy induces a significant volumetric reduction of colorectal plaques when evaluated by endoscopic ultrasonography.
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Some literature data suggest that OCs may be safely used in women with colorectal endometriosis.
“Although some literature data suggest that OCs may be safely used in women with colorectal endometriosis (12,29)”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as [12]
The Results report adverse effects but no treatment interruptions, and the Discussion says an estrogen–progestogen combination may be offered to symptomatic women with bowel endometriosis that does not cause functional stenosis. The Discussion also explicitly says the findings cannot be generalized to all women with colorectal endometriosis, so the unqualified population in the claim is broader than the study supports. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn the same prospective case series of 22 women, there was a high satisfaction rate at the end of the study period (69% of women were satisfied or very satisfied).
“High satisfaction rate at the end of study period (69% of women were satisfied or very satisfied).”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as [12]
The Results report that 19% were very satisfied and 50% were satisfied at the end of the study, supporting the stated 69%. However, the Material and methods describe a prospective study of 26 women, not 22. (LLM, conf=0.90)
Experimental — accuracy not yet measuredIn a prospective case series of 22 women with bowel endometriosis, continuous low-dose monophasic oral contraceptive (EE 15 μg + gestodene 60 μg)/day for 12 months significantly improved dysmenorrhea, dyspareunia, chronic pelvic pain, and dyschezia.
“Significant improvement of dysm, dysp, CPP, and dyschezia.”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as [12]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn the same prospective case series of 22 women, the treatment significantly reduced nodule size after 12 months.
“Significant reduction of nodule size after 12 months of treatment.”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as [12]
The Results report that nodule diameter and volume decreased significantly after 12 months of treatment (p<0.01). However, the Abstract and Figure 1 identify 26 women, not the 22 stated in the claim. (LLM, conf=0.93)
Experimental — accuracy not yet measuredIn women with colorectal endometriosis and intestinal lumen stenosis ≤50%, continuous low-dose monophasic OC for 12 months decreased nodule volume by 62%.
“Ferrari et al . (12) treated 26 patients with colorectal endometriotic lesions infiltrating the tunica muscularis with a low-dose, monophasic OC used continuously for 12 months.”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as Ferrari et al. (12)
At 1-year evaluation, 18 of 26 (69%) women with colorectal endometriosis treated with continuous low-dose OC were satisfied or very satisfied.
“At 1-year evaluation, 18 patients (69%) were satisfied or very satisfied with their treatment, four were uncertain, and four were dissatisfied or very dissatisfied.”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as Ferrari et al. (12)
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Cites
Endometriosis and pelvic pain: relation to disease stage and localization
Vercellini, P., Trespidi, L., De Giorgi, O., Cortesi, I., Parazzini, F., & Crosignani, P. G. (1996) · Fertility and Sterility · doi:10.1016/s0015-0282(16)58089-3 · Cited by 457 · see citing works
The effect of surgery for symptomatic endometriosis: the other side of the story
Vercellini, P., Crosignani, P. G., Abbiati, A., Somigliana, E., Viganò, P., & Fedele, L. (2009) · Human Reproduction Update · doi:10.1093/humupd/dmn062 · Cited by 339 · see citing works
Bowel Endometriosis: Presentation, Diagnosis, and Treatment
Remorgida, V., Ferrero, S., Fulcheri, E., Ragni, N., & Martin, D. C. (2007) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000268688.55653.5c · Cited by 329 · see citing works
Dosage aspects of danazol therapy in endometriosis: Short-term and long-term effectiveness
Biberoglu, K. O., & Behrman, S. J. (1981) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(81)90478-6 · Cited by 267 · see citing works
Pain, mast cells, and nerves in peritoneal, ovarian, and deep infiltrating endometriosis
Anaf, V., Chapron, C., El Nakadi, I., De Moor, V., Simonart, T., & Noël, J.-C. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.03.057 · Cited by 258 · see citing works
Long-term follow-up after conservative surgery for rectovaginal endometriosis
Fedele, L., Bianchi, S., Zanconato, G., Bettoni, G., & Gotsch, F. (2004) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2003.10.698 · Cited by 216 · see citing works
Postoperative oral contraceptive exposure and risk of endometrioma recurrence
Vercellini, P., Somigliana, E., Daguati, R., Vigano, P., Meroni, F., & Crosignani, P. G. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.11.010 · Cited by 196 · see citing works
Self-citationDeep Endometriosis: Definition, Pathogenesis, and Clinical Management
Vercellini, P., Frontino, G., Pietropaolo, G., Gattei, U., Daguati, R., & Crosignani, P. G. (2004) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)60190-9 · Cited by 180 · see citing works
Remorgida, V., Ragni, N., Ferrero, S., Anserini, P., Torelli, P., & Fulcheri, E. (2005) · Human Reproduction · doi:10.1093/humrep/dei047 · Cited by 171 · see citing works
Minelli, L. (2009) · Archives of Surgery · doi:10.1001/archsurg.2008.555 · Cited by 170 · see citing works
Ford, J., English, J., Miles, W. F. A., & Giannopoulos, T. (2004) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2004.00093.x · Cited by 157 · see citing works
Chapron, C., Vieira, M., Chopin, N., Balleyguier, C., Barakat, H., Dumontier, I., Roseau, G., Fauconnier, A., Foulot, H., & Dousset, B. E. (2004) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.1107 · Cited by 156 · see citing works
Reproductive performance in infertile women with rectovaginal endometriosis: Is surgery worthwhile?
Vercellini, P., Pietropaolo, G., Giorgi, O. D., Daguati, R., Pasin, R., & Crosignani, P. G. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2006.03.068 · Cited by 154 · see citing works
Medical treatment for rectovaginal endometriosis: what is the evidence?
Vercellini, P., Crosignani, P. G., Somigliana, E., Berlanda, N., Barbara, G., & Fedele, L. (2009) · Human Reproduction · doi:10.1093/humrep/dep231 · Cited by 144 · cited 4× · see citing works
“Conversely, progestogens are known to have favorable biological effects on deep infiltrating endometriosis-associated mast cells (9).”
BackgroundResultInfluentialEndometriosis: current and future medical therapies
Vercellini, P., Somigliana, E., Viganò, P., Abbiati, A., Daguati, R., & Crosignani, P. G. (2007) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2007.10.001 · Cited by 136 · see citing works
Progesterone Inhibits Mast Cell Secretion
Vasiadi, M., Kempuraj, D., Boucher, W., Kalogeromitros, D., & Theoharides, T. C. (2006) · International Journal of Immunopathology and Pharmacology · doi:10.1177/039463200601900408 · Cited by 107 · see citing works
Surgery for Deep Endometriosis: A Pathogenesis-Oriented Approach
Vercellini, P., Carmignani, L., Rubino, T., Barbara, G., Abbiati, A., & Fedele, L. (2009) · Gynecologic and Obstetric Investigation · doi:10.1159/000219946 · Cited by 83 · see citing works
Letrozole and norethisterone acetate in colorectal endometriosis
Ferrero, S., Camerini, G., Ragni, N., Venturini, P. L., Biscaldi, E., Seracchioli, R., & Remorgida, V. (2010) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2010.02.023 · Cited by 80 · see citing works
Bergamini, V., Ghezzi, F., Scarperi, S., Raffaelli, R., Cromi, A., & Franchi, M. P. (2010) · Abdominal Imaging · doi:10.1007/s00261-010-9610-z · Cited by 57 · see citing works
Abdominal Pain, Bloating, and Urgency
Ferrero, S., Abbamonte, L. H., Remorgida, V., et al. (2005) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000169600.45875.b1 · Cited by 19 · see citing works
Post-operative digestive symptoms after colorectal resection for endometriosis
Ferrero, S., Ragni, N., & Remorgida, V. (2006) · Human Reproduction · doi:10.1093/humrep/del101 · Cited by 14 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Medical treatment of endometriosis-related pain
Vercellini, P., Buggio, L., Frattaruolo, M. P., Borghi, A., Dridi, D., & Somigliana, E. (2018) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2018.01.015 · Cited by 188 · see citing works
Jensen, J. T., Schlaff, W., & Gordon, K. (2018) · Fertility and Sterility · doi:10.1016/j.fertnstert.2018.03.012 · Cited by 113 · see citing works
Leone Roberti Maggiore, U., Remorgida, V., Scala, C., Tafi, E., Venturini, P. L., & Ferrero, S. (2014) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/aogs.12326 · Cited by 80 · see citing works
Role of medical therapy in the management of deep rectovaginal endometriosis
Vercellini, P., Buggio, L., & Somigliana, E. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.08.038 · Cited by 62 · see citing works
Vercellini, P., Frattaruolo, M. P., Rosati, R., Dridi, D., Roberto, A., Mosconi, P., De Giorgi, O., Cribiù, F. M., & Somigliana, E. (2018) · Human Reproduction · doi:10.1093/humrep/dex364 · Cited by 44 · see citing works
Fukuda, S., Hirata, T., Neriishi, K., Nakazawa, A., Takamura, M., Izumi, G., Harada, M., Hirota, Y., Koga, K., Wada-Hiraike, O., et al. (2018) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2018.04.021 · Cited by 44 · see citing works
Diagnosis, management, and long-term outcomes of rectovaginal endometriosis
Moawad, N., & Caplin, A. (2013) · International Journal of Women's Health · doi:10.2147/ijwh.s37846 · Cited by 41 · see citing works
Vercellini, P., Buggio, L., Borghi, A., Monti, E., Gattei, U., & Frattaruolo, M. P. (2018) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/aogs.13328 · Cited by 39 · see citing works
Management of endometriosis: Toward value-based, cost-effective, affordable care
Vercellini, P., Facchin, F., Buggio, L., Barbara, G., Berlanda, N., Frattaruolo, M. P., & Somigliana, E. (2018) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2017.07.011 · Cited by 36 · see citing works
- Authors
- FERRARI, S., PERSICO, P., DI PUPPO, F., VIGANO, P., TANDOI, I., GARAVAGLIA, E., GIARDINA, P., MEZZI, G., & CANDIANI, M.
- Affiliations
- IRCCS Ospedale San Raffaele (IT)
- Vita-Salute San Raffaele University (IT)
- Venue
- Acta Obstetricia et Gynecologica Scandinavica
- Publisher
- Wiley
- Published
- 2012-03-05
- Volume
- 91
- Issue
- 6
- Pages
- 699-703
- ISSN
- 0001-6349 (ISSN-L)
- 1600-0412
- OpenAlex
- W1491539436
- Cited by
- 38
- References
- 21
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 7 · 2019: 3 · 2018: 5 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 2
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Surgery › Gastrointestinal disorders and treatments
- Keywords
- bowel endometriosis, colorectal endometriosis, ethinyl estradiol, gestodene, nodule volume reduction, dysmenorrhea, pelvic pain, dyspareunia, painful defecation
- MeSH terms
- Adult, Colonic Diseases, Contraceptives, Oral, Synthetic, Dose-Response Relationship, Drug, Drug Combinations, Dysmenorrhea, Dyspareunia, Endometriosis, Ethinyl Estradiol, Female, Humans, Norpregnenes, Pain Measurement, Prospective Studies, Rectal Diseases, Pelvic Pain, Endosonography
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