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Deep endometriosis

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https://www.readbyqxmd.com/read/29222825/outcome-of-sonography-based-minimally-invasive-surgery-for-deep-infiltrating-endometriosis-of-the-ureter-and-urinary-bladder-a-retrospective-cohort-study
#1
Gernot Hudelist, Ayman Tammaa, Kristine Aas-Eng, Lisa Kirchner, Nadja Fritzer, Zoltan Nemeth, Michael Lamche
INTRODUCTION: To evaluate the accuracy of transvaginal sonography for preoperative detection of bladder endometriosis and surgical outcomes regarding fertility and pain symptoms of women with urinary tract endometriosis. MATERIAL AND METHODS: Retrospective cohort study of consecutive patients with urinary tract endometriosis undergoing laparoscopic partial cystectomy and/or ureterolysis/decompression, ureteric resection and end-to-end anastomosis or ureteroneocystostomy for ureteral stenosis and hydronephrosis...
December 8, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29202966/choosing-the-right-surgical-technique-for-deep-endometriosis-shaving-disc-excision-or-bowel-resection
#2
REVIEW
Olivier Donnez, Horace Roman
Deep endometriosis (DE) remains the most difficult endometriotic entity to treat. Medical treatment for DE can reduce symptoms but does not cure the disease, and surgical removal of the lesion is required when lesions are symptomatic, impairing bowel, urinary, sexual, and reproductive functions. Although several surgical techniques such as laparoscopic bowel resection, disc excision, and rectal shaving have been described, there is no consensus regarding the choice of technique or the timing of surgery. Our review of publications reporting results and complications of surgery for rectovaginal DE reveals a relatively higher complication rate after bowel resection compared with shaving and disc excision, especially for rectovaginal fistulas, anastomotic leakage, delayed hemorrhage, and long-term bladder catheterization...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29202965/role-of-medical-therapy-in-the-management-of-deep-rectovaginal-endometriosis
#3
REVIEW
Paolo Vercellini, Laura Buggio, Edgardo Somigliana
Defining whether medical therapy is effective in women with deep rectovaginal endometriosis and in which circumstances it can be considered an alternative to surgery is important for patients and physicians. Numerous observational and some randomized controlled studies demonstrated that different hormonal drugs improved pain and other symptoms in approximately two-thirds of women with deep rectovaginal endometriosis. Because major differences in the effect size of various compounds were not observed, much importance should be given to safety, tolerability, and cost of medications when counseling patients...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29202964/obstetrical-complications-of-endometriosis-particularly-deep-endometriosis
#4
REVIEW
Umberto Leone Roberti Maggiore, Annalisa Inversetti, Matteo Schimberni, Paola Viganò, Veronica Giorgione, Massimo Candiani
Over the past few years, a new topic in the field of endometriosis has emerged: the potential impact of the disease on pregnancy outcomes. This review aims to summarize in detail the available evidence on the relationship between endometriosis, particularly deep endometriosis (DE), and obstetrical outcomes. Acute complications of DE, such as spontaneous hemoperitoneum, bowel perforation, and uterine rupture, may occur during pregnancy. Although these events represent life-threatening conditions, they are rare and unpredictable...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29202963/diagnosis-of-deep-endometriosis-clinical-examination-ultrasonography-magnetic-resonance-imaging-and-other-techniques
#5
REVIEW
Marc Bazot, Emile Daraï
The aim of the present review was to evaluate the contribution of clinical examination and imaging techniques, mainly transvaginal sonography and magnetic resonance imaging (MRI) to diagnose deep infiltrating (DE) locations using prisma statement recommendations. Clinical examination has a relative low sensitivity and specificity to diagnose DE. Independently of DE locations, for all transvaginal sonography techniques a pooled sensitivity and specificity of 79% and 94% are observed approaching criteria for a triage test...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29202962/introduction-from-pathogenesis-to-therapy-deep-endometriosis-remains-a-source-of-controversy
#6
Jacques Donnez
Deep endometriosis remains a source of controversy. A number of theories may explain its pathogenesis and many arguments support the hypothesis that genetic or epigenetic changes are a prerequisite for development of lesions into deep endometriosis. Deep endometriosis is frequently responsible for pelvic pain, dysmenorrhea, and/or deep dyspareunia, but can also cause obstetrical complications. Diagnosis may be improved by high-quality imaging. Therapeutic approaches are a source of contention as well. In this issue's Views and Reviews, medical and surgical strategies are discussed, and it is emphasized that treatment should be designed according to a patient's symptoms and individual needs...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29200236/diagnostics-of-endometriosis-by-using-magnetic-resonance-imaging
#7
Eija Pääkkö, Maarit Niinimäki
Endometriosis affects about 2 to 10% of women in fertile age, It causes pain and infertility. In the ovaries, endometrios causes endometriomas. The disease may spread into the abdominal cavity and even result in ileus. Deep endometriomas are located under the peritoneal surface, typically behind the uterus and in the region of uterosacral ligaments. History, clinical examination and transvaginal ultrasound scanning usually lead to the diagnosis. Magnetic resonance imaging is in particular utilized prior to surgery...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29194531/conservative-surgery-versus-colorectal-resection-in-deep-endometriosis-infiltrating-the-rectum-a-randomized-trial
#8
Horace Roman, Michael Bubenheim, Emmanuel Huet, Valérie Bridoux, Chrysoula Zacharopoulou, Emile Daraï, Pierre Collinet, Jean-Jacques Tuech
STUDY QUESTION: Is there a difference in functional outcome between conservative versus radical rectal surgery in patients with large deep endometriosis infiltrating the rectum 2 years postoperatively? SUMMARY ANSWER: No evidence was found that functional outcomes differed when conservative surgery was compared to radical rectal surgery for deeply invasive endometriosis involving the bowel. WHAT IS KNOWN ALREADY: Adopting a conservative approach to the surgical management of deep endometriosis infiltrating the rectum, by employing shaving or disc excision, appears to yield improved digestive functional outcomes...
November 29, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29193230/deep-infiltrating-endometriosis-comparison-between-2-dimensional-ultrasonography-us-3-dimensional-us-and-magnetic-resonance-imaging
#9
Stefano Guerriero, Juan Luis Alcázar, Maria Angela Pascual, Silvia Ajossa, Maura Perniciano, Alba Piras, Valerio Mais, Bruno Piras, Federica Schirru, Melis Gian Benedetto, Luca Saba
OBJECTIVES: To evaluate the diagnostic accuracy of 2-dimensional (2D) and 3-dimensional (3D) transvaginal ultrasonography (US) in comparison with magnetic resonance imaging (MRI) for identification of deep infiltrating endometriosis. METHODS: In this prospective observational study, 159 premenopausal women who underwent surgery for a clinical suspicion of deep infiltrating endometriosis were prospectively enrolled. All women underwent 2DUS, 3DUS, and MRI. The following 3 locations of deep endometriosis were considered: (1) intestinal; (2) other posterior lesions (retrocervical septum, rectovaginal septum, uterosacral ligaments, and vaginal fornix); and (3) anterior...
November 30, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29170015/-detrusor-sphincter-disorders-associated-with-deep-endometriosis-systematic-review-of-the-literature
#10
A Grouin, A Florian, A C Sans Mischel, O Toullalan
CONTEXT: Detrusor sphincter disorders impact quality of life in case of deep endometriosis. Surgery, which is one of the main treatments, is responsible of detrusor sphincter disorders. Since then, it is essential to look for those disorders and find the right medical care. OBJECTIVE: To specify the detrusor sphincter disorders, its links with anatomical localisation of deep endometriosis and its prognosis after surgery. METHODS: A literature review was carried out via PubMed(®) with the followings keywords: "deep endometriosis", "urinary disorders", "voiding dysfunction" and "urinary dysfunction"...
November 20, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/29169709/-creation-of-expert-centers-on-endometriosis
#11
Emile Daraï, Sofiane Bendifallah, Nathalie Chabbert-Buffet, François Golfier
Endometriosis is a frequent pathology with a high incidence of deep infiltrating endometriosis and complex forms that can affect 20% of patients with endometriosis. The incidence of infertility associated with endometriosis can reach 50%. The complexity of care requires the creation of expert centers working in networks with general practitioners. Criteria for defining these expert centers are being drawn up, based on structural criteria (multidisciplinary consultation meeting), links with medical assistance structures for procreation and activity criteria for severe and complex forms (number of interventions per center and per surgeon)...
November 20, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29166801/endometriosis-resembling-endometrial-cancer-in-a-postmenopausal-patient
#12
B Suchońska, M Gajewska, A Zyguła, M Wielgoś
Endometriosis occurs in 2-4% of postmenopausal women. There have been a few reports of endometriosis in women in whom neither history nor diagnostic imaging indicated the presence of this disease, either at reproductive age or after menopause. A case is described of an 84-year-old patient with extensive deep pelvic endometriosis imitating advanced neoplastic process.
November 23, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/29154402/transvaginal-ultrasound-tvs-versus-magnetic-resonance-mr-for-diagnosing-deep-infiltrating-endometriosis-a-systematic-review-and-meta-analysis
#13
REVIEW
S Guerriero, L Saba, M A Pascual, S Ajossa, I Rodriguez, V Mais, J L Alcazar
OBJECTIVES: To perform a systematic review of studies comparing the diagnostic accuracy of TVS and MRI in Deep Infiltrating Endometriosis (DIE) including only studies in which patients have been underwent both techniques. METHODS: An extensive search of papers comparing TVS and MRI in DIE was performed in Medline (Pubmed) and Web of Sciences from January 1989 to January 2016. Studies were considered eligible if they reported on the use of TVS and MRI in the same set of patients for the preoperative detection of endometriosis in pelvic locations in women with clinical suspicion of DIE using the surgical data as a reference standard...
November 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29147655/magnetic-resonance-colonography-may-predict-the-need-for-bowel-resection-in-colorectal-endometriosis
#14
Arnaldo Scardapane, Filomenamila Lorusso, Mariantonietta Francavilla, Stefano Bettocchi, Fabiana Divina Fascilla, Giuseppe Angelelli, Marco Scioscia
Purpose: To define if MRI findings in patients with deep pelvic endometriosis (DPE) may be predictive for the need of bowel resection. Material and Methods: A retrospective survey of 196 pelvic MRIs of women who received laparoscopic procedures for DPE was carried out. A pelvic MRI was performed in all patients: it consisted in T2w-TSE sequences in axial, sagittal, and coronal planes and T1w and THRIVE sequences in the axial plane; the exam was completed by MR-Colonography...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29132241/rectovaginal-fistula-following-surgery-for-deep-infiltrating-endometriosis-does-lesion-size-matter
#15
Yunxi Zheng, Ning Zhang, Weiqi Lu, Liang Zhang, Shouxin Gu, Ying Zhang, Xiaofang Yi, Keqin Hua
Objective This study was performed to identify risk factors for postoperative rectovaginal fistula (PRF) in patients with deep infiltrating endometriosis (DIE). Methods Data were retrospectively obtained from the medical records of 104 patients with DIE, and statistical analysis was used to detect risk factors for PRF. Results Five of 104 (4.8%) patients developed PRF from 5 to 16 days postoperatively. The operative procedures included 84 (80.8%) superficial excisions, 6 (5.8%) full-thickness disc excisions, and 14 (13...
September 26, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29129415/-ivf-and-endometriosis-oocyte-donation-and-fertility-preservation
#16
Emmanuelle Mathieu d'Argent, Jean-Marie Antoine
Endometriosis is a common condition, causing pain and infertility. In infertile woman with superficial peritoneal endometriosis and patent tubes, laparoscopy is recommended, followed by ovarian stimulation alone or in combination with intrauterine inseminations. In case of ovarian or deep endometriosis, the indications of surgery and assisted reproductive technologies remain to be defined precisely. In vitro fertilization is generally proposed after the failure of up to three inseminations, directly for ovarian or deep endometriosis, or in case of an associated factor of infertility, mainly male...
November 9, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29129414/-surgical-management-of-deep-infiltrating-endometriosis-with-bowel-involvement-and-urinary-tract-involvement
#17
Sofiane Bendifallah, Marcos Ballester, Emile Darai
Endometriosis is a benign pathology that affects 3% of the general population and about 10% of women of reproductive age. Three anatomoclinical entities are described: peritoneal, ovarian (endometrioma) and deep endometriosis characterized by the infiltration of anatomical structures or organs beyond the peritoneum. Laparoscopic surgery should be performed, as this is associated with a reduction in postoperative complications, length of hospitalization and convalescence. Several surgical techniques allow the removal of deep endometriosis with colorectal involvement: rectal shaving, anterior discoid resection, segmental resection...
November 9, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29129409/-fertility-and-deep-infiltrating-endometriosis
#18
Jonathan Cohen, Emmanuelle Mathieu d'Argent, Lise Selleret, Jean-Marie Antoine, Nathalie Chabbert-Buffet, Sofiane Bendifallah, Marcos Ballester, Emile Darai
Deep infiltrating endometriosis is the most severe form of the disease, defined by infiltration beneath the peritoneum greater than 5mm. It affects several anatomical locations including the bladder, the vesico-uterine cul-de-sac, the torus uterinum, the uterosacral ligament, rectovaginal septum and the colon-rectum. Deep infiltrating endometriosis is associated with infertility. Surgery performed for deep infiltrating endometriosis in the context of pain offers good pregnancy rates either spontaneously or after assisted reproductive technologies...
November 9, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29126882/the-role-of-mri-dti-in-predicting-pain-related-to-endometriosis-a-preliminary-study
#19
Maria Grazia Porpora, Valeria Vinci, Corrado De Vito, Giuseppe Migliara, Emanuela Anastasi, Adele Ticino, Serena Resta, Carlo Catalano, Pierluigi Benedetti Panici, Lucia Manganaro
OBJECTIVE: To evaluate the sacral nerve root features by the means of Magnetic Resonance Imaging Diffusion Tensor Imaging (MRI-DTI) tractography in women with endometriosis and /or adenomyosis and to analyze the correlation between DTI abnormalities, pain symptoms, and endometriotic lesions found at surgery. DESIGN: A cross-sectional, observational study (Canadian Task Force classification II-2) SETTING: University hospital PATIENTS: 76 women with clinical suspicion of endometriosis ...
November 7, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29126089/fertility-outcomes-after-laparoscopic-partial-bladder-resection-for-deep-endometriosis-retrospective-analysis-from-two-expert-centres-and-review-of-the-literature
#20
Krystel Nyangoh Timoh, Marcos Ballester, Sofiane Bendifallah, Arnaud Fauconnier, Emile Darai
OBJECTIVE: To evaluate fertility outcomes after laparoscopic partial bladder resection in women with bladder endometriosis and to review the literature. STUDY DESIGN: A retrospective study conducted at two tertiary referral centres -Tenon University Hospital and Poissy University Hospital (Canadian Task Force Classification Level II-2)-from July 2006 to November 2015. Patients with bladder endometriosis who underwent either laparoscopic partial bladder resection (PBR) alone for those without posterior endometriotic lesions (PBR group) or both laparoscopic PBR and associated posterior deep infiltrating endometriosis (DIE) resection (PBR-PDIE group) were included...
October 31, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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