Department of Obstetrics and Gynecology, LMU University Hospital, Munich, Germany.
Institute for Stochastics and Applications, University of Stuttgart, Stuttgart, Germany.
Ultraschall Med. 2024 Jun;45(3):285-292. doi: 10.1055/a-2209-5653. Epub 2023 Dec 15.
The progression of deep endometriosis (DE) in women of reproductive age is highly variable. This study aimed to analyze the sonomorphological changes of rectal endometriosis over long periods of time and the influence of hormonal treatment.
This retrospective study included premenopausal women with rectal DE treated conservatively between 2002 and 2021. The lesion length and thickness of the nodule were evaluated at regular intervals over time. We created statistical models with mixed effects to identify potential factors influencing lesion progression and regression.
38 patients were monitored over a mean period of 7.2 (± 4.2) years with a mean of 3.1 (± 2.1) check-ups within the observation period. We detected a significant increase in lesion length until the end of the fourth decade of life. In addition, we found a substantial decrease in the length and thickness of the nodule depending on the length of hormonal treatment.
In conservatively managed patients with rectal endometriosis, without hormonal therapy, lesion size can exhibit a moderate increase up to the end of the fourth decade of life, after which it appears to stabilize. This increase does not follow a linear pattern. Hormonal therapy is crucial in impeding further progression, resulting in either a cessation or a regression of lesion growth.
育龄期女性深部子宫内膜异位症（DE）的进展具有高度可变性。本研究旨在分析直肠子宫内膜异位症的超声形态变化及其激素治疗的影响。
这是一项回顾性研究，纳入了 2002 年至 2021 年间接受保守治疗的直肠 DE 的绝经前女性。定期评估结节的病变长度和厚度。我们使用混合效应统计模型来确定影响病变进展和消退的潜在因素。
38 例患者在平均 7.2（±4.2）年的时间内进行了监测，在观察期内平均进行了 3.1（±2.1）次检查。我们发现病变长度在第四十年生命期结束前显著增加。此外，我们发现，根据激素治疗的时间长短，结节的长度和厚度均有显著减少。
在接受保守治疗且未接受激素治疗的直肠子宫内膜异位症患者中，病变大小在第四十年生命期结束前可能会适度增加，之后似乎趋于稳定。这种增加并非呈线性模式。激素治疗对于阻止进一步进展至关重要，可导致病变生长停止或消退。
