Keckstein J, Wiesinger H. Deep endometriosis, including intestinal involvement--the interdisciplinary approach.
MINIM INVASIV THER 2007;
14:160-6. [PMID:
16754158 DOI:
10.1080/14017430510035916]
[Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Deep endometriosis is a disease which may involve all organs of the pelvis. The lesion is most often located at the backside of the uterus, involving the uterosacral ligaments and/or the rectovaginal septum. The involvement of adjacent organs, e.g. bowel, ureter, and bladder, makes an interdisciplinary approach necessary. There is a correlation between the radicalness of endometriosis resection and the postoperative improvement of complaints. In a series of 202 patients with deep endometriosis including the bowel we performed a segmental resection with anterior anastomosis including radical excision of all endometriotic lesions. The follow-up of 142 patients shows a significant improvement of pelvic pain (96%), dyschezia (88%), and dyspareunia (87%). Of 95 patients with a desire for children, 50% became pregnant. The postoperative complication rate was low. A leakage of anastomosis was seen in six cases (3%).
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