Role of medical therapy in the management of deep rectovaginal endometriosis

Paolo Vercellini; Laura Buggio; Edgardo Somigliana

doi:10.1016/j.fertnstert.2017.08.038

Role of medical therapy in the management of deep rectovaginal endometriosis

Paolo Vercellini, Laura Buggio, Edgardo Somigliana

Fertility and sterility · 2017 · vol. 108(6) , pp. 913–930 · doi:10.1016/j.fertnstert.2017.08.038 · PMID:29202965 · W2773939391

review OA: bronze CC0 ⤵ 44 in-corpus citations

🔓 Open OA copy View on OpenAlex View on PubMed View at publisher

⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper reviews the current role of medical therapies, including hormonal and non-hormonal agents, in managing deep rectovaginal endometriosis.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

My notes (saved in your browser only)

Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Endometrium Hormones Rectal Diseases Vaginal Diseases Animals Biopsy Colposcopy Endometriosis Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Estrogens Estrogens Female Hormones Hormones

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (98)

Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients via openalex
Association rate between deep peritoneal endometriosis and other forms of the disease: pathogenetic implications via openalex
Bladder Endometriosis: A Rare but Challenging Condition via openalex
‘Blood On The Tracks’ from corpora lutea to endometriomas* via openalex
Changes in the size of rectovaginal endometriotic nodules infiltrating the rectum during hormonal therapies via openalex
Combined Oral Contraceptive Therapy in Women with Posterior Deep Infiltrating Endometriosis via openalex
Complications and long‐term follow‐up on colorectal resections in the treatment of deep infiltrating endometriosis extending to bowel wall via openalex
Continuous low‐dose oral contraceptive in the treatment of colorectal endometriosis evaluated by rectal endoscopic ultrasonography via openalex
Deep endometriosis conundrum: evidence in favor of a peritoneal origin via openalex
Deep endometriosis: definition, diagnosis, and treatment via openalex
Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management via openalex
Deep Infiltrating Endometriosis Treatment with Dienogest: A Pilot Study via openalex
Diagnostic accuracy of transvaginal ultrasound for non‐invasive diagnosis of bowel endometriosis: systematic review and meta‐analysis via openalex
Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission via openalex
Dienogest in women with persistent endometriosis-related pelvic pain during norethisterone acetate treatment via openalex
Disclosure in scientific meetings: should we take any steps further? via openalex
Effects of dienogest, a synthetic steroid, on experimental endometriosis in rats via openalex
Efficacy and acceptability of long-term norethindrone acetate for the treatment of rectovaginal endometriosis via openalex
Efficacy of elagolix in the treatment of endometriosis via openalex
Efficacy of vaginal danazol treatment in women with recurrent deeply infiltrating endometriosis via openalex
Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications via openalex
Endometriosis: pathogenesis and treatment via openalex
Endometriosis: the elusive gray area between evidence-based and evidence-biased medicine via openalex
Endometriosis: What a Pain It Is via openalex
Estrogen and progesterone receptors in smooth muscle component of deep infiltrating endometriosis via openalex
Estrogen-progestins and progestins for the management of endometriosis via openalex
Gonadotropin-releasing hormone agonist treatment for endometriosis of the rectovaginal septum via openalex
Ileocecal endometriosis: clinical and pathogenetic implications of an underdiagnosed condition via openalex
Immunohistochemical analysis of proliferative activity and steroid receptor expression in peritoneal and ovarian endometriosis via openalex
Important role of collective cell migration and nerve fiber density in the development of deep nodular endometriosis via openalex
Improvement of digestive complaints in women with severe colorectal endometriosis benefiting from continuous amenorrhoea triggered by triptorelin. A prospective pilot study via openalex
Induction of endometriotic nodules in an experimental baboon model mimicking human deep nodular lesions via openalex
Invasion process of induced deep nodular endometriosis in an experimental baboon model: similarities with collective cell migration? via openalex
Is ureteral endometriosis an asymmetric disease? via openalex
Lack of Transparency of Clinical Trials on Endometriosis via openalex
Laparoscopic aspiration of ovarian endometriomas. Effect with postoperative gonadotropin releasing hormone agonist treatment. via openalex
Laparoscopic Colorectal Resection for Bowel Endometriosis via openalex
Laparoscopic uterosacral ligament resection for dysmenorrhea associated with endometriosis: results of a randomized, controlled trial via openalex
Letrozole and norethisterone acetate in rectovaginal endometriosis via openalex
Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial via openalex
Long‐term adjuvant therapy for the prevention of postoperative endometrioma recurrence: a systematic review and meta‐analysis via openalex
Long-Term Progestin Treatment Inhibits RANTES (Regulated on Activation, Normal T Cell Expressed and Secreted) Gene Expression in Human Endometrial Stromal Cells via openalex
Medical treatment for rectovaginal endometriosis: what is the evidence? via openalex
Nerve fiber density in deep nodular endometriotic lesions induced in a baboon experimental model via openalex
Norethindrone acetate or dienogest for the treatment of symptomatic endometriosis: a before and after study via openalex
Novel vaginal danazol ring therapy for pelvic endometriosis, in particular deeply infiltrating endometriosis via openalex
Oxidative stress in the pelvic cavity and its role in the pathogenesis of endometriosis via openalex
Partial suppression of estradiol: a new strategy in endometriosis management? via openalex
Postoperative Levonorgestrel-Releasing Intrauterine System for Pelvic Endometriosis-Related Pain via openalex
Postoperative maintenance levonorgestrel-releasing intrauterine system and endometrioma recurrence: a randomized controlled study via openalex
Postoperative oral contraceptive exposure and risk of endometrioma recurrence via openalex
Preoperative work-up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitely be the first-line imaging examination via openalex
Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills via openalex
Reduction of the intraperitoneal inflammation associated with endometriosis by treatment with medroxyprogesterone acetate via openalex
Reevaluating response and failure of medical treatment of endometriosis: a systematic review via openalex
Reproductive performance in infertile women with rectovaginal endometriosis: Is surgery worthwhile? via openalex
REVIEW: Evidence for asymmetric distribution of lower intestinal tract endometriosis via openalex
Role of the vaginally administered aromatase inhibitor anastrozole in women with rectovaginal endometriosis: a pilot study via openalex
Smooth muscles are frequent components of endometriotic lesions via openalex
Surgery for Deep Endometriosis: A Pathogenesis-Oriented Approach via openalex
Surgery versus hormonal therapy for deep endometriosis: is it a choice of the physician? via openalex
Surgical versus low-dose progestin treatment for endometriosis-associated severe deep dyspareunia II: Effect on sexual functioning, psychological status and health-related quality of life via openalex
Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group via openalex
Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy via openalex
Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist via openalex
Treatment of symptomatic rectovaginal endometriosis with an estrogen–progestogen combination versus low-dose norethindrone acetate via openalex
Ultrasound mapping system for the surgical management of deep infiltrating endometriosis via openalex
Use of a levonorgestrel-releasing intrauterine device in the treatment of rectovaginal endometriosis via openalex
Vaginal danazol for women with rectovaginal endometriosis and pain symptoms persisting after insertion of a levonorgestrel‐releasing intrauterine device via openalex
Vaginally Administered Danazol: An Overlooked Option in the Treatment of Rectovaginal Endometriosis? via openalex
'Waiting for Godot': a commonsense approach to the medical treatment of endometriosis via openalex
What Is Known and Unknown About the Association Between Endometriosis and Sexual Functioning: A Systematic Review of the Literature via openalex
When love hurts. A systematic review on the effects of surgical and pharmacological treatments for endometriosis on female sexual functioning via openalex
W6603060888 via openalex
W78459228 via openalex
W1672184366 via openalex
W1966091296 via openalex
W1976666756 via openalex
W2006390573 via openalex
W2024158781 via openalex
W2033247060 via openalex
W2039104184 via openalex
W2045089102 via openalex
W2065390631 via openalex
W2085075316 via openalex
W2085922363 via openalex
W2100503022 via openalex
W2110802986 via openalex
W2126339803 via openalex
W2130203785 via openalex
W2137282066 via openalex
W2138118457 via openalex
W2152955646 via openalex
W2157853773 via openalex
W2164754530 via openalex
W2168488550 via openalex
W2401134385 via openalex
W2765750028 via openalex

Cited by (44)

Source provenance

europepmc: last seen: 2026-06-11T06:19:48.454388+00:00
openalex: last seen: 2026-06-10T17:14:06.276822+00:00
pubmed: last seen: 2026-05-13T22:20:07.505861+00:00

License: CC0 · commercial use OK

[1] Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients via openalex

[2] Association rate between deep peritoneal endometriosis and other forms of the disease: pathogenetic implications via openalex

[3] Bladder Endometriosis: A Rare but Challenging Condition via openalex

[4] ‘Blood On The Tracks’ from corpora lutea to endometriomas* via openalex

[5] Changes in the size of rectovaginal endometriotic nodules infiltrating the rectum during hormonal therapies via openalex

[6] Combined Oral Contraceptive Therapy in Women with Posterior Deep Infiltrating Endometriosis via openalex

[7] Complications and long‐term follow‐up on colorectal resections in the treatment of deep infiltrating endometriosis extending to bowel wall via openalex

[8] Continuous low‐dose oral contraceptive in the treatment of colorectal endometriosis evaluated by rectal endoscopic ultrasonography via openalex

[9] Deep endometriosis conundrum: evidence in favor of a peritoneal origin via openalex

[10] Deep endometriosis: definition, diagnosis, and treatment via openalex

[11] Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management via openalex

[12] Deep Infiltrating Endometriosis Treatment with Dienogest: A Pilot Study via openalex

[13] Diagnostic accuracy of transvaginal ultrasound for non‐invasive diagnosis of bowel endometriosis: systematic review and meta‐analysis via openalex

[14] Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission via openalex

[15] Dienogest in women with persistent endometriosis-related pelvic pain during norethisterone acetate treatment via openalex

[16] Disclosure in scientific meetings: should we take any steps further? via openalex

[17] Effects of dienogest, a synthetic steroid, on experimental endometriosis in rats via openalex

[18] Efficacy and acceptability of long-term norethindrone acetate for the treatment of rectovaginal endometriosis via openalex

[19] Efficacy of elagolix in the treatment of endometriosis via openalex

[20] Efficacy of vaginal danazol treatment in women with recurrent deeply infiltrating endometriosis via openalex

[21] Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications via openalex

[22] Endometriosis: pathogenesis and treatment via openalex

[23] Endometriosis: the elusive gray area between evidence-based and evidence-biased medicine via openalex

[24] Endometriosis: What a Pain It Is via openalex

[25] Estrogen and progesterone receptors in smooth muscle component of deep infiltrating endometriosis via openalex

[26] Estrogen-progestins and progestins for the management of endometriosis via openalex

[27] Gonadotropin-releasing hormone agonist treatment for endometriosis of the rectovaginal septum via openalex

[28] Ileocecal endometriosis: clinical and pathogenetic implications of an underdiagnosed condition via openalex

[29] Immunohistochemical analysis of proliferative activity and steroid receptor expression in peritoneal and ovarian endometriosis via openalex

[30] Important role of collective cell migration and nerve fiber density in the development of deep nodular endometriosis via openalex

[31] Improvement of digestive complaints in women with severe colorectal endometriosis benefiting from continuous amenorrhoea triggered by triptorelin. A prospective pilot study via openalex

[32] Induction of endometriotic nodules in an experimental baboon model mimicking human deep nodular lesions via openalex

[33] Invasion process of induced deep nodular endometriosis in an experimental baboon model: similarities with collective cell migration? via openalex

[34] Is ureteral endometriosis an asymmetric disease? via openalex

[35] Lack of Transparency of Clinical Trials on Endometriosis via openalex

[36] Laparoscopic aspiration of ovarian endometriomas. Effect with postoperative gonadotropin releasing hormone agonist treatment. via openalex

[37] Laparoscopic Colorectal Resection for Bowel Endometriosis via openalex

[38] Laparoscopic uterosacral ligament resection for dysmenorrhea associated with endometriosis: results of a randomized, controlled trial via openalex

[39] Letrozole and norethisterone acetate in rectovaginal endometriosis via openalex

[40] Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial via openalex

[41] Long‐term adjuvant therapy for the prevention of postoperative endometrioma recurrence: a systematic review and meta‐analysis via openalex

[42] Long-Term Progestin Treatment Inhibits RANTES (Regulated on Activation, Normal T Cell Expressed and Secreted) Gene Expression in Human Endometrial Stromal Cells via openalex

[43] Medical treatment for rectovaginal endometriosis: what is the evidence? via openalex

[44] Nerve fiber density in deep nodular endometriotic lesions induced in a baboon experimental model via openalex

[45] Norethindrone acetate or dienogest for the treatment of symptomatic endometriosis: a before and after study via openalex

[46] Novel vaginal danazol ring therapy for pelvic endometriosis, in particular deeply infiltrating endometriosis via openalex

[47] Oxidative stress in the pelvic cavity and its role in the pathogenesis of endometriosis via openalex

[48] Partial suppression of estradiol: a new strategy in endometriosis management? via openalex

[49] Postoperative Levonorgestrel-Releasing Intrauterine System for Pelvic Endometriosis-Related Pain via openalex

[50] Postoperative maintenance levonorgestrel-releasing intrauterine system and endometrioma recurrence: a randomized controlled study via openalex

[51] Postoperative oral contraceptive exposure and risk of endometrioma recurrence via openalex

[52] Preoperative work-up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitely be the first-line imaging examination via openalex

[53] Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills via openalex

[54] Reduction of the intraperitoneal inflammation associated with endometriosis by treatment with medroxyprogesterone acetate via openalex

[55] Reevaluating response and failure of medical treatment of endometriosis: a systematic review via openalex

[56] Reproductive performance in infertile women with rectovaginal endometriosis: Is surgery worthwhile? via openalex

[57] REVIEW: Evidence for asymmetric distribution of lower intestinal tract endometriosis via openalex

[58] Role of the vaginally administered aromatase inhibitor anastrozole in women with rectovaginal endometriosis: a pilot study via openalex

[59] Smooth muscles are frequent components of endometriotic lesions via openalex

[60] Surgery for Deep Endometriosis: A Pathogenesis-Oriented Approach via openalex

[61] Surgery versus hormonal therapy for deep endometriosis: is it a choice of the physician? via openalex

[62] Surgical versus low-dose progestin treatment for endometriosis-associated severe deep dyspareunia II: Effect on sexual functioning, psychological status and health-related quality of life via openalex

[63] Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group via openalex

[64] Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy via openalex

[65] Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist via openalex

[66] Treatment of symptomatic rectovaginal endometriosis with an estrogen–progestogen combination versus low-dose norethindrone acetate via openalex

[67] Ultrasound mapping system for the surgical management of deep infiltrating endometriosis via openalex

[68] Use of a levonorgestrel-releasing intrauterine device in the treatment of rectovaginal endometriosis via openalex

[69] Vaginal danazol for women with rectovaginal endometriosis and pain symptoms persisting after insertion of a levonorgestrel‐releasing intrauterine device via openalex

[70] Vaginally Administered Danazol: An Overlooked Option in the Treatment of Rectovaginal Endometriosis? via openalex

[71] 'Waiting for Godot': a commonsense approach to the medical treatment of endometriosis via openalex

[72] What Is Known and Unknown About the Association Between Endometriosis and Sexual Functioning: A Systematic Review of the Literature via openalex

[73] When love hurts. A systematic review on the effects of surgical and pharmacological treatments for endometriosis on female sexual functioning via openalex

[74] W6603060888 via openalex

[75] W78459228 via openalex

[76] W1672184366 via openalex

[77] W1966091296 via openalex

[78] W1976666756 via openalex

[79] W2006390573 via openalex

[80] W2024158781 via openalex

[81] W2033247060 via openalex

[82] W2039104184 via openalex

[83] W2045089102 via openalex

[84] W2065390631 via openalex

[85] W2085075316 via openalex

[86] W2085922363 via openalex

[87] W2100503022 via openalex

[88] W2110802986 via openalex

[89] W2126339803 via openalex

[90] W2130203785 via openalex

[91] W2137282066 via openalex

[92] W2138118457 via openalex

[93] W2152955646 via openalex

[94] W2157853773 via openalex

[95] W2164754530 via openalex

[96] W2168488550 via openalex

[97] W2401134385 via openalex

[98] W2765750028 via openalex