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Rectovaginal endometriosis

Gaetano Gallo, Alberto Realis Luc, Roberta Tutino, Giuseppe Clerico, Mario Trompetto
AIM: The deep infiltrating endometriosis, defined as a subperitoneal infiltration of endometrial implants of ≥ 5 mm involving not only the colorectal tract but also rectovaginal septum, vagina and bladder often requires a challenging surgery. Endometriosis nodes of the rectovaginal septum, if symptomatic, need a resection of the involved colorectal tract with colorectal or coloanal anastomosis. Unfortunately in these cases is not uncommon the possibility of a postoperative rectovaginal fistula (RVF), caused by the weakness of the septum that must be skeletonized to completely remove the endometriosis nodes...
November 28, 2016: Annali Italiani di Chirurgia
X Yi, Y Zheng, K Hua
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
J-P Estrade
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Antonio Simone Laganà, Salvatore Giovanni Vitale, Maria Antonietta Trovato, Vittorio Italo Palmara, Agnese Maria Chiara Rapisarda, Roberta Granese, Emanuele Sturlese, Rosanna De Dominici, Stefano Alecci, Francesco Padula, Benito Chiofalo, Roberta Grasso, Pietro Cignini, Paolo D'Amico, Onofrio Triolo
Endometriosis is defined as the presence of endometrial mucosa (glands and stroma) abnormally implanted in locations other than the uterine cavity. Deep infiltrating endometriosis (DIE) is considered the most aggressive presentation of the disease, penetrating more than 5 mm in affected tissues, and it is reported in approximately 20% of all women with endometriosis. DIE can cause a complete distortion of the pelvic anatomy and it mainly involves uterosacral ligaments, bladder, rectovaginal septum, rectum, and rectosigmoid colon...
2016: BioMed Research International
Nicola Berlanda, Edgardo Somigliana, Maria Pina Frattaruolo, Laura Buggio, Dhouha Dridi, Paolo Vercellini
Deep endometriosis, occurring approximately in 1% of women of reproductive age, represents the most severe form of endometriosis. It causes severe pain in the vast majority of affected women and it can affect the bowel and the urinary tract. Hormonal treatment of deep endometriosis with progestins, such as norethindrone acetate or dienogest, or estroprogestins is effective in relieving pain in more than 90% of women at one year follow up. Progestins and estroprogestins can be safely administered in the long-term, may be not expensive and are usually well tolerated...
August 8, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Giuseppe Piccinni, Giuseppe Massimiliano De Luca, Stefano Lafranceschina, Antonio Biondi, Andrea Marzullo, Angela Gurrado, Mario Testini
Endometriosis occurs in 5%-10% of fertile women, usually in the pelvic region, such as the ovaries, uterine ligaments, pelvic peritoneum, and rectovaginal septum. A mesenteric endometriotic cyst is an exceptional observation and difficult to diagnose preoperatively. We report a case of a large mesenteric endometriotic cyst treated by laparoscopy. A 21-year-old Caucasian woman was admitted as an emergency to our Academic Hospital on the 30th day postpartum for abdominal pain and a palpable epigastric mass. A CT scan revealed a mass measuring 7...
August 11, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
O Delépine, S Curinier, N Agar, G Piquier-Perret, D Gallot, C Houlle, M Canis, J-L Pouly
Endometriosis is a common condition in women, whose main repercussions are painful symptoms. In addition, it was shown that endometriosis was a major cause of infertility and various obstetric complications could be related to this pathology. Uterine rupture is a rare but serious complication whose incidence tends to decrease with the screening of women at risk, however, its fetal, maternal morbidity and mortality causes remains important. We were confronted with a case of posterior uterine rupture in a patient of 36 years, primipare term exceeded in immediate postpartum period...
August 2, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
D Liu, H M Shen, Y C Liang, W Wang, T Y Liu, C L Shang, S Z Yao
OBJECTIVE: To evaluate the efficacy and quality of life of segmental bowel resection for bowel endometriosis. METHODS: Totally 62 symptomatic patients with bowel endometriosis undergoing segmental bowel resection were recruited. A visual analogue scale(VAS)and the 36-item short form health survey(SF-36)questionnaire were administered before and at least 1 year after surgery, respectively. Pregnancy rates were also recorded. RESULTS: Sixty-two patients in total underwent follow-up ranging from 12 to 74 months...
July 25, 2016: Zhonghua Fu Chan Ke za Zhi
Caterina Exacoustos, Ilaria Lauriola, Lucia Lazzeri, Giovanna De Felice, Errico Zupi
OBJECTIVE: To study outcomes and complications during pregnancy and at delivery in women with a posterior deep infiltrating endometriosis (DIE) nodule persisting after surgery and diagnosed at transvaginal sonography (TVS) in comparison with a control group of women without endometriosis. DESIGN: Multicenter observational and cohort study. SETTING: University hospital. PATIENT(S): Women (n = 200) with a posterior DIE nodule equal or more than 2 cm centimeters in size who desired a pregnancy and a control group of women (n = 300) with no previous recorded diagnosis of endometriosis who delivered in our clinic during the same time period...
October 2016: Fertility and Sterility
Vicki Nisenblat, Lucy Prentice, Patrick M M Bossuyt, Cindy Farquhar, M Louise Hull, Neil Johnson
BACKGROUND: About 10% of women of reproductive age suffer from endometriosis, a costly chronic disease causing pelvic pain and subfertility. Laparoscopy is the gold standard diagnostic test for endometriosis, but is expensive and carries surgical risks. Currently, there are no non-invasive tests available in clinical practice to accurately diagnose endometriosis. This review assessed the diagnostic accuracy of combinations of different non-invasive testing modalities for endometriosis and provided a summary of all the reviews in the non-invasive tests for endometriosis series...
July 13, 2016: Cochrane Database of Systematic Reviews
G P Fragulidis, F V Oreopulu, A Vezakis, C Sofoudis, E Kalambokas, V Koutoulidis, N F Vlahos
Endometriosis represents a main cause of infertility and pelvic pain affecting 3-43% among reproductive age women. Deep pelvic endometriosis is defined as subperitoneal infiltration of endometrial implants in the uterosacral ligaments, rectum, rectovaginal septum, vagina or bladder. The authors present a case of a 29-year-old patient who underwent laparoscopic excision of extensive endometriotic plaque in rectovaginal septum accompanied with deeply infiltrating endometriosis (DIE) and chronic pelvic pain (CPP)...
2016: Clinical and Experimental Obstetrics & Gynecology
E A Kogan, A S Ovakimyan, N B Paramonova, N M Faizullina, I F Kazachenko, L V Adamyan
UNLABELLED: Endometriosis (EM) is morphologically characterized by the development of extrauterine endometrioid heterotopies, the major clinical symptoms of which is chronic pelvic pain, which is a serious problem not only in modern gynecology, but also in public health as a whole. AIM: to investigate neurogenic markers in the foci of EM of various sites and histological structure in women with and without pain syndrome. MATERIAL AND METHODS: The investigation was performed using the operative material (resected segments of the intestine, bladder, rectovaginal septum, and small pelvic peritoneum) obtained from 52 women with an intraoperative and morphologically verified diagnosis of EM and (Group 1) and without (Group 2) pain syndrome...
May 2016: Arkhiv Patologii
Gaby N Moawad, Elias D Abi Khalil, David Samuel
STUDY OBJECTIVE: To demonstrate a stepwise surgical technique of robotic-assisted transabdominal cerclage placement in a patient with deeply infiltrative endometriosis DESIGN: Step-by-step surgical tutorial using narrated video. SETTING: The George Washington University Hospital. The local Institutional Review Board approval is not required for case reports. PATIENTS: 38 year-old woman with cervical incompetence and history of infertility with five pregnancies accomplished by in-vitro fertilization...
April 27, 2016: Journal of Minimally Invasive Gynecology
Jonathan Cohen, Marcos Ballester, Lise Selleret, Emmanuelle Mathieu D'Argent, Jean M Antoine, Nathalie Chabbert-Buffet, Emile Darai
Deep infiltrating endometriosis (DIE) affects several anatomical locations including the bladder, torus uterinum, uterosacral ligament, rectovaginal septum and bowel. It is the most debilitating form of endometriosis and causes severe pain, digestive and urinary symptoms as well as infertility. Faced with an infertile woman suffering from DIE, the dilemma is whether to opt for first-line IVF treatment or for surgery. In the absence of high-level of evidence from randomized studies, several factors should be taken into account in the decision-making process...
December 2016: Minerva Ginecologica
John R Lue, Adam Pyrzak, Jennifer Allen
Endometriosis continues to be a major primary gynecologic etiology of chronic pelvic pain. The symptom profile, which includes cyclic pelvic pain, dysmenorrhea, and dyspareunia or dyschezia, is nonspecific and does not correlate with the extent or severity of disease. Trans-vaginal or trans-rectal ultrasound, as well as magnetic resonance imaging, can help visualize endometriomas and deeply infiltrating endometriosis. Additionally, there have been no serum marker tests available so far. However, even intraoperatively, the diagnosis may be missed, leading to under diagnosis and delayed or noninitiation of treatment...
April 2016: Journal of Minimal Access Surgery
Sergio Eduardo Alonso Araujo, Victor Edmond Seid, Renato Moretti Marques, Mariano Tamura Vieira Gomes
For symptomatic deep infiltrating endometriosis, surgery is often required to achieve symptom relief and restore fertility. A minimally invasive approach using laparoscopy is considered the gold standard. However, specific limitations of the laparoscopic approach deep in the pelvis keep challenging even surgeons with a solid experience with minimally invasive techniques. Robotic surgery has the potential to compensate for technical drawbacks inherent in conventional laparoscopic surgery, such as limited degree of freedom, two-dimensional vision, and the fulcrum effect...
June 2016: Journal of Robotic Surgery
Miłosz Wilczyński, Monika Wiecka-Płusa, Beata Antosiak, Grazyna Maciołek-Blewniewska, Dominika Majchrzak-Baczmańska, Andrzej Malinowski
OBJECTIVES: The aim of the study was a retrospective analysis of the medical records of patients who underwent surgery due to deep infiltrating rectovaginal endometriosis (mainly with the use of the 'shaving' technique). MATERIAL AND METHODS: We analysed 160 cases of patients who underwent surgery due to the deep infiltrating rectovaginal endometriosis in our ward between 2003-2014. Depending on lesion localization, disease severity and clinical characteristics, three possible ways of operation were proposed: laparoscopic, vaginal or a combined vagino-laparoscopic approach...
December 2015: Ginekologia Polska
N Krawczyk, M Banys-Paluchowski, D Schmidt, U Ulrich, T Fehm
Endometriosis is a common condition in women of reproductive age. According to several epidemiological studies endometriosis may be associated with increased risk of various malignancies. However, endometriosis-associated malignancy (EAM) is defined by certain histological criteria. About 80 % of EAM have been found in the ovary, whereas 20 % are localized in extragonadal sites like intestine, rectovaginal septum, abdominal wall, pleura and others. Some authors suggest that EAM arise from atypical endometriosis as an intermediate lesion between endometriosis and cancer...
February 2016: Geburtshilfe und Frauenheilkunde
Ourania Koukoura, Stavros Sifakis, Demetrios A Spandidos
Endometriosis is defined by the presence and growth of functional endometrial tissue, outside the uterine cavity, primarily in the ovaries, pelvic peritoneum and rectovaginal septum. Although it is a benign disease, it presents with malignant characteristics, such as invasion to surrounding tissues, metastasis to distant locations and recurrence following treatment. Accumulating evidence suggests that various epigenetic aberrations may play an essential role in the pathogenesis of endometriosis. Aberrant DNA methylation represents a possible mechanism repsonsible for this disease, linking gene expression alterations observed in endometriosis with hormonal and environmental factors...
April 2016: Molecular Medicine Reports
Vicki Nisenblat, Patrick M M Bossuyt, Cindy Farquhar, Neil Johnson, M Louise Hull
BACKGROUND: About 10% of women of reproductive age suffer from endometriosis. Endometriosis is a costly chronic disease that causes pelvic pain and subfertility. Laparoscopy, the gold standard diagnostic test for endometriosis, is expensive and carries surgical risks. Currently, no non-invasive tests that can be used to accurately diagnose endometriosis are available in clinical practice. This is the first review of diagnostic test accuracy of imaging tests for endometriosis that uses Cochrane methods to provide an update on the rapidly expanding literature in this field...
February 26, 2016: Cochrane Database of Systematic Reviews
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