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Open AccessArticle

Long-Term Administration of Dienogest for the Treatment of Pain and Intestinal Symptoms in Patients with Rectosigmoid Endometriosis

1
Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, Italy
2
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, 16132 Genoa, Italy
3
Unit of Obstetrics and Gynecology, Gaslini Institute, 16147 Genova, Italy
4
Department of Gynecologic Oncology, IRCCS National Cancer Institute, 20133 Milan, Italy
5
Piazza della Vittoria 14 S.r.l., 16121 Genova, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(1), 154; https://doi.org/10.3390/jcm9010154 (registering DOI)
Received: 9 December 2019 / Revised: 28 December 2019 / Accepted: 5 January 2020 / Published: 6 January 2020
(This article belongs to the Special Issue Diagnosis and Management of Endometriosis and Uterine Fibroids)
Background: Rectosigmoid endometriosis is a severe form of deep endometriosis, which may be responsible for pain symptoms and a wide range of intestinal complains such as diarrhea, constipation, and abdominal cramping. The primary objective of this study was to evaluate the efficacy of long-term therapy with dienogest (DNG), a fourth-generation progestin, for ameliorating quality of life, pain, and intestinal symptoms of patients affected by rectosigmoid endometriosis. Methods: A retrospective analysis of a prospectively collected database was done on patients with endometriotic nodules infiltrating at least the muscular layer of the rectosigmoid wall with an estimated colorectal stenosis <60%. The diagnosis of rectosigmoid endometriosis was based on transvaginal ultrasonography. Patients accepting to participate in the study received continuous oral treatment with DNG at the dose of 2 mg/day. Results: At the end of the first year of treatment, a significant decrease in dysmenorrhea (P < 0.001), chronic pelvic pain (P < 0.001), dyspareunia (P < 0.001), dyschezia (P < 0.001), and in intestinal symptoms (P < 0.001) was observed. A progressive increase of the Endometriosis Health Profile-30 (EHP-30) and Gastrointestinal Quality of Life Index (GIQLI) scores was observed in the first two years of therapy (P < 0.001 and P < 0.001, respectively). Improvements of patients’ symptoms and quality of life were maintained until the end of the study. The regimen was well tolerated, and the frequency and amount of irregular bleeding decreased as treatment progressed. Conclusion: The current study confirms the efficacy of long-term therapy with DNG for treating symptoms caused by rectosigmoid endometriosis. View Full-Text
Keywords: rectosigmoid endometriosis; dienogest; hormonal treatment; pain; intestinal symptoms rectosigmoid endometriosis; dienogest; hormonal treatment; pain; intestinal symptoms
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Barra, F.; Scala, C.; Leone Roberti Maggiore, U.; Ferrero, S. Long-Term Administration of Dienogest for the Treatment of Pain and Intestinal Symptoms in Patients with Rectosigmoid Endometriosis. J. Clin. Med. 2020, 9, 154.

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