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VP62.02: Evaluation of sonographic changes after one year of combined oral contraceptive continuous regimens in endometriosis patients

Ultrasound in Obstetrics & Gynecology(2020)

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Abstract
The aim of our study was to analyse the sonographic changes of endometriosis patients who have received combined oral contraceptive continuous regimens (COCCR) for at least 1 year of duration. A total of 566 endometriosis patients were evaluated. A specialised ultrasound was performed searching for ovarian endometriomas (OE) and intestinal, torus, retrocervical, vaginal and vesical deep infiltrating endometriosis (DIE). To be eligible, patients had to undergo a sonographic examination prior to initiation of treatment and a second one after a year with COCCR. The impact of the treatment was measured in terms of the decrease in size of OE and DIE nodules. Finally, 94 patients were analysed. Expressed as mean+/-standard deviation (SD) or n(%). The mean age was 38.4+/-4.6 years. At the start, the sonographic evaluation showed, 68 (72.3%) patients with OE, 39 (41.5%) affected by intestinal DIE, 45 (47.9%) by torus DIE and 24 (25.5%) by retrocervical DIE. Four cases of vaginal and 3 of vesical DIE were reported. A significant decrease in number of patients with OE was noted (pre-treatment: n = 68 (72.3%); post-treatment: n = 50 (53.2%) [p < 0.0001]). Moreover, a decrease in size of persistent OE was objectified (pre-treatment mean 45.6 +/-3.86mm; post-treatment 26.6 +/-4.39mm [p < 0.0001]). All DIE lesions were still visible in the follow-up. A significant decrease in the size of torus (pre-treatment 23.6 +/- 1.75mm; post-treatment 18.8 +/- 1.19mm [p < 0.0091]) and retrocervical DIE (pre-treatment 20.2 +/- 1.93mm; post-treatment 14.4 +/- 1.55mm [p < 0.025]) was noted. Nevertheless, intestinal (pre-treatment 25.4 +/- 1.54mm; post-treatment 23.4 +/- 1.50mm [p = 0.34]), vaginal and vesical DIE remained stable during follow-up. Our research demonstrates a significant reduction of endometriosis sonographic features after COCCR at 1-year-follow-up. The improvement is more evident in OE compared with DIE. More studies with a larger sample and a longer follow-up, are warranted.
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sonographic changes
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