Ferrero Simone, Scala Carolina, Ciccarelli Stefano, Vellone Valerio Gaetano, Barra Fabio
Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genova, Italy.
Gynecol Endocrinol. 2020 Jun;36(6):540-544. doi: 10.1080/09513590.2019.1689552. Epub 2019 Nov 12.
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.
本研究旨在探讨释放依托孕烯（ENG）的植入剂治疗直肠阴道子宫内膜异位症患者的疗效。该研究基于对前瞻性收集的数据库进行回顾性分析，纳入经超声诊断为直肠阴道子宫内膜异位症的有症状女性。患者在植入释放ENG的植入剂后6、12和24个月进行随访。使用视觉模拟量表评估疼痛症状的强度。通过虚拟器官计算机辅助分析估计结节的体积。采用子宫内膜异位症健康量表（EHP - 30）评估生活质量。总体而言，43名女性纳入本研究。释放ENG的植入剂的2年持续使用率为93.0%。该治疗迅速改善了非经期盆腔疼痛、深部性交困难、痛经和排便困难的强度。在6个月随访时，与基线相比，EHP - 30的所有领域均有改善。仅在12个月随访时疼痛子评分以及24个月随访时情绪健康子评分中观察到EHP - 30结果进一步改善。在6个月随访时，直肠阴道结节的体积与基线相比显著降低；在12个月和24个月随访时观察到进一步减小。该治疗耐受性良好。
