Advances in the medical management of bowel endometriosis

Endometriosis infiltrating the bowel can be treated medically in accurately selected women not seeking conception and without overt obstructive symptomatology. When rectosigmoid junction is involved, probabilities of intestinal symptoms relief, undergoing surgery after treatment failure, developing obstruction during hormonal are around 70%, 10%, 1–2%, respectively. lesion infiltrates exclusively mid-rectum, thus cases true rectovaginal endometriosis, relief about 80% 3%, Endometriotic obstructions rectal ampulla have been reported. A rectosigmoidoscopy or colonoscopy should performed systematically before starting medical therapies, also to rule out malignant tumours arising from mucosa. Progestogens safe, generally effective, well-tolerated, inexpensive, considered as first-line medications for endometriosis. Independently symptom lesions checked periodically exclude nodule progression treatment.