{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T06:43:50Z","timestamp":1786171430084,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Deep endometriosis (DE) involving the bowel presents a complex management challenge. While surgery is often emphasized, limited evidence exists on long\u2010term outcomes of conservative (non\u2010surgical) management. This study aimed to evaluate quality of life (QoL), symptoms, bowel, and urinary function in patients with bowel DE managed conservatively over a nearly 7\u2010year period. A secondary aim was to compare initial characteristics of those who later underwent surgery versus those who remained conservatively treated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Patients diagnosed with bowel DE and managed conservatively with hormonal therapy were originally enrolled in a prospective study and followed up nearly 7\u2009years later. Follow\u2010up data were collected using validated online questionnaires: Short Form Health Survey 36 (SF\u201036) and Endometriosis Health Profile\u201030 (EHP\u201030) for QoL; the Low Anterior Resection Score (LARS) for bowel function; and the International Consultation on Incontinence Questionnaire\u2013Female Lower Urinary Tract Symptoms (ICIQ\u2010FLUTS) for urinary symptoms. Patients who had entered menopause or undergone bowel surgery or oophorectomy were excluded, as were patients pregnant at the time of follow\u2010up. For the analysis related to the secondary aim, data collected 1\u2009year from baseline was used, assessing any differences between those who later required surgery and those who remained conservatively managed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010two patients remained on conservative management throughout the follow\u2010up. QoL (SF\u201036 and EHP\u201030) and bowel\/urinary symptoms (LARS, ICIQ\u2010FLUTS) remained stable. A significant reduction in dysmenorrhea was observed, while intermenstrual pain and dyschezia remained unchanged. Painkiller use tended to decrease. At follow\u2010up, 15% reported major LARS. Seventy\u2010three patients were included in the secondary analysis. Among respondents, 19% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914) underwent bowel resection or total oophorectomy during the follow\u2010up. These patients had significantly larger bowel lesions, higher pain scores, and lower SF\u201036 \u201cbodily pain\u201d scores, reflecting poorer QoL compared to those who remained conservatively managed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over nearly 7\u2009years of follow\u2010up, most patients with bowel DE managed conservatively maintained stable symptoms and a relatively high QoL. One fifth required surgery, and these patients exhibited worse pain and QoL years prior to intervention. Conservative hormonal therapy appears to be a viable long\u2010term option in selected patients, underscoring the importance of individualized, symptom\u2010oriented treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70290","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T10:54:34Z","timestamp":1784285674000},"page":"1848-1859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term insights: Seven years of conservative management for deep endometriosis in the bowel"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2292-2637","authenticated-orcid":false,"given":"Gitte Bro","family":"Schmidt","sequence":"first","affiliation":[{"name":"Horsens Regional Hospital  Horsens Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrik Schi\u00f8ler","family":"Kesmodel","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Aalborg University Hospital  Aalborg Denmark"},{"name":"Aalborg University  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6595-4636","authenticated-orcid":false,"given":"Mikkel","family":"Seyer\u2010Hansen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Gynecology and Obstetrics Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8346-932X","authenticated-orcid":false,"given":"Anne Gisselmann","family":"Egekvist","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of 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