trelstar and Colonic-Diseases

Topics: Adult; Antineoplastic Agents, Hormonal; Colonic Diseases; Endometriosis; Female; Humans; Prospective Studies; Rectal Diseases; Triptorelin Pamoate

To explore whether operation can change the elasticity of levator ani in deep infiltrating endometriosis (DIE) with operation and pharmacotherapy using transperineal elastography.. Total thirty-four patients who were diagnosed as DIE were included in the study. Transperineal elastography were performed in all cases preoperatively and postoperatively. The levator ani was evaluated by means of the scoring system and strain ratio (SR) values on maximal Valsalva and quiescent condition, respectively.. On quiescent condition, the preoperative mean elastography scores and SR of the levator ani were statistically significantly higher than the postoperative ones in both shaving technique group and segmental colorectal resection group. And on maximal Valsalva, the preoperative mean elastography scores and SR of the levator ani were statistically significantly lower than the postoperative ones in both groups. After surgery and 6 cycles of GnRHa therapy, the mean elastography score and SR of the levator ani were statistically significantly lower than before GnRHa therapy in shaving technique group on quiescent condition. And on maximal Valsalva, the mean elastography score and SR were statistically higher than before GnRHa therapy. However, in segmental colorectal resection group, the differences were not observed before and following 6 cycles of GnRHa therapy.. The elasticity of levator ani of DIE was changed by both shaving technique and segmental colorectal resection. And transperineal elastography could access the alterations.

Topics: Adult; Colonic Diseases; Elasticity; Elasticity Imaging Techniques; Endometriosis; Female; Humans; Pelvic Floor; Postoperative Period; Rectal Diseases; Retrospective Studies; Treatment Outcome; Triptorelin Pamoate

To assess the impact of therapeutic amenorrhoea triggered by triptorelin in the digestive complaints of women with deep endometriosis infiltrating the rectum.. Prospective series of consecutive patients with deep endometriosis of the rectum enrolled over a period of 17 consecutive months.. University tertiary referral center.. Seventy patients.. Medical therapy (triptorelin 11.25 mg and add-back therapy using estradiol) administered for 3.4±1.8months before surgery.. Gastrointestinal standardised questionnaires before beginning medical treatment and the day before surgery.. The most frequent digestive complaints at baseline were: defecation pain in 77.1% of patients, bloating in 60%, diarrhoea in 54.3% and constipation in 50%. The largest diameter of the rectal area infiltrated by the disease was <1cm in 12.2% of women, 1 to 2.9 cm in 34.3% and ≥3cm in 51.4%. Multiple colorectal nodules were found in 32.9%. Medical treatment led to disappearance of cyclic defecation pain in 78.6%, dyschesia in 58.3%, diarrhoea in 58.3% and bloating in 50%. Relieving digestive complaints was not significantly related to either length of triptorelin administration or size of rectal infiltration by deep endometriosis.. Therapeutic amenorrhoea averaging 3 months allowed complete improvement of various cyclic digestive complaints in more than half of patients. In selected patients, continuous therapeutic amenorrhoea could compensate for the lack of complete resection of deep infiltrating endometriosis of the rectum, when this latter is likely to result in a high rate of postoperative morbidity.

Topics: Amenorrhea; Colonic Diseases; Digestive System Diseases; Endometriosis; Female; Humans; Luteolytic Agents; Pain; Prospective Studies; Rectal Diseases; Triptorelin Pamoate

Endometriosis concerns 10% of childbearing age women and frequently affects the digestive tract. We report here the case of a 31-year-old patient presenting a severe occlusive syndrome while being treated with GnRH agonist, within the framework of an in vitro fertilization. The surgical treatment will find a deep endometriosis affecting the sigmoid and colorectal junction and leading to a colorectal resection. These endometriosis lesion recurrences during ovarian stimulation or by GnRH flare up effect is rare and often debated. The surgical treatment of the lesions, before the medically assisted procreation, seems to prevent these complications.

Topics: Adult; Colon, Sigmoid; Colonic Diseases; Endometriosis; Female; Fertilization in Vitro; Gonadotropin-Releasing Hormone; Humans; Infertility, Female; Intestinal Obstruction; Rectal Diseases; Tomography, X-Ray Computed; Triptorelin Pamoate