Dienogest. A possible conservative approach in bladder endometriosis. Results of a pilot study

Abstract

Deep endometriosis involvement of the bladder is uncommon but it is symptomatic in most of the cases. Although laparoscopic excision is very effective, some patients with no pregnancy desire require a medical approach. We performed a pilot study on the effect of a new progestin dienogest on bladder endometriosis. Six patients were treated for 12 months with dienogest 2 mg/daily. Pain, urinary symptoms, quality of life, nodule volume and side effects were recorded. During treatment, symptoms improved very quickly and the nodules exhibit a remarkable reduction in size. Dienogest may be an alternative approach to bladder endometriosis.

Bladder Endometriosis: A Systematic Review of Pathogenesis, Diagnosis, Treatment, Impact on Fertility, and Risk of Malignant Transformation

“…Agarwal et al [98] observed relief of catamenial dysuria and hematuria and a >50% reduction in lesion size in a woman treated with dienogest for 16 mo for a 3-cm endometriotic bladder nodule. Angioni et al [99] used the same dienogest dose for 1 yr in six women who requested a medical approach for BE. Their pain and urinary symptoms improved very quickly and the nodule decreased remarkably in size in all patients [99].…”

“…Angioni et al [99] used the same dienogest dose for 1 yr in six women who requested a medical approach for BE. Their pain and urinary symptoms improved very quickly and the nodule decreased remarkably in size in all patients [99]. Leone Roberti Maggiore et al [39] used dienogest 2 mg/d to treat a 34-yr-old nulliparous woman with urgency and stress urinary incontinence associated with BE who refused surgery.…”

Primary umbilical endometriosis successfully treated with dienogest

“…In animal studies, dienogest demonstrated anti-proliferative, anti-inflammatory and anti-angiogenic effects towards endometriosis tissue [12]. In clinical trials, dienogest has been reported to be successful in reducing both the symptoms and the size of rectosigmoid and bladder endometriosis after 10 to 11 months of usage [14]. Until now, no literature has described the success of dienogest in treating PUE.…”

Oral and depot progestin therapy for endometriosis: towards a personalized medicine

“…Women in DNG group reported a significant amelioration compared to control group in pain symptoms and QoL at the first follow-up, and in Another field of application of DNG treatment is bladder endometriosis. A recent pilot study [35] on six patients treated for 12 months with DNG 2 mg/d showed an improvement of pain symptoms in all patients. In particular, urinary symptoms disappeared and at transvaginal ultrasound a significant decrease of bladder nodule size at 3-and 12-months evaluation was described.…”