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| Therapeutic effect of transvaginal partial resection of rectovaginal endometriosis combined with levonorgestrel intrauterine release system or oral drospirenone and ethinyl estradiol |
| 3201 Hospital Affiliated to Xi'an Jiaotong University, Hanzhong, Shaanxi Province，723000 |
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Abstract To explore the therapeutic effect of transvaginal partial resection of rectovaginal endometriosis (RVE) combined with levonorgestrel intrauterine release system or oral drospirenone and ethinyl estradiol. Methods: 41 patients with RVE from February 2015 to September 2018 were collected retrospectively. After the patients were all treated with transvaginal partial resection of RVE, 21 patients in the observation group were given levonorgestrel sustained-release intrauterine system, and 20 patients in the control group were given oral drospirenone and ethinyl estradiol. The changes of dysmenorrheal rate, dyspareunia rate, VAS score of chronic pelvic pain, pictorial blood loss assessment chart (PBAC) score, and the level of carbohydrate antigen (CA) 125 of patients before treatment and 6 months after treatment were compared between the two groups. The adverse reactions of patients in the two groups were recorded, and the recurrence rate of patients in the two groups was followed up for 12 months after treatment. Results: After 6 months of treatment, VAS scores of dysmenorrheal, dyspareunia and chronic pelvic pain, CA125 level, and PBAC score of the patients had decreased significantly (P＜0.05), but those of the patients had no significant different between the two groups (P＞0.05). The rate of adverse reactions, such as breast pain, weight gain, abnormal menstruation, acne and other of patients in observation group was 52.4%, which was significant higher than that (20.0%) of the patients in the control group (P＜0.05). 1 year followed up, there were 1 (4.8%) case with RVE recurrence in the observation group, and 2 (10.0%) cases with RVE recurrence in the control group, but the recurrence rate had no significant different between the two groups (P＞0.05). Conclusion: Transvaginal resection of RVE combined with levonorgestrel intrauterine sustained release system or oral drospirenone and ethinyl estradiol for continuous control can improve the symptoms of RVE and promote its prognosis. However, levonorgestrel intrauterine sustained release system has higher adverse reaction, so the choices of drug for continue intervention after surgery should be consider the needs and indications of patients.
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