Dienogest for the treatment of deep endometriosis: case report and literature review

Sugandha Agarwal, Agarwal S, M.A. Fraser, Margaret Ann Fraser, Fraser MA, Innie Chen, Singh SS, Sukhbir Sony Singh, Sukhbir S. Singh
Journal of Obstetrics and Gynaecology Research · 2014 · vol. 41(2) , pp. 309–313 · doi:10.1111/jog.12527 · PMID:25303112 · W1536926543
Review OA: closed CC0 ⤵ 21 in-corpus citations
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This case report found dienogest treatment reduced deep endometriosis nodule size in a patient with bladder and vaginal implants, leading to symptom resolution without significant side effects.

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Abstract

A 38-year-old woman was found to have a deep 3.3-cm endometriotic nodule of the bladder, confirmed by cystoscopic resection and imaging. Ultrasound also confirmed a 2.6-cm vaginal fornix implant with similar appearance to the bladder mass. The patient's primary symptoms were mild dysmenorrhea, catamenial dysuria and hematuria. The patient conceived shortly after referral and 3 months post-delivery was offered surgical management but declined in favor of medical management. Dienogest 2 mg once a day was started and after 16 months of treatment, more than 50% reduction in the size of the bladder nodule was seen (pretreatment: 3.3 × 3.0 × 2.7 cm, volume: 13.9 cm(3) ; post-treatment: 2.8 × 2.3 × 1.0 cm, volume: 6.4 cm(3) ). The vaginal mass also decreased in size from a pretreatment value of 2.0 × 2.6 × 1.4 cm (3.8 cm(3) ) to 1.1 × 1.4 × 0.5 mm (0.40 cm(3) ) after the treatment. The patient remained asymptomatic with no significant adverse drug reaction during management. Dienogest may be one of the options for medical management of deep endometriosis in young women especially when surgical intervention is declined.

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Condition tags

endometriosisdysmenorrhea

MeSH descriptors

Endometriosis Hormone Antagonists Nandrolone Urinary Bladder Diseases Vaginal Diseases Adult Adult Endometriosis Endometriosis Female Female Hormone Antagonists Hormone Antagonists Humans Humans Nandrolone Nandrolone Nandrolone Urinary Bladder Diseases Urinary Bladder Diseases

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (21)

Cited by (21)

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License: CC0 · commercial use OK