Surgical Therapy of Endometriosis: Challenges and Controversies

Overview

Journal Geburtshilfe Frauenheilkd

Specialty Gynecology & Obstetrics

Date 2014 Apr 29

PMID 24771943

Citations 14

Authors

S Rimbach

U Ulrich

K W Schweppe

Affiliations

Soon will be listed here.

Abstract

Endometriosis is one of the most common disorders encountered in surgical gynaecology. The laparoscopic technique, the planning of the surgical intervention, the extent of information provided to patients and the interdisciplinary coordination make it a challenging intervention. Complete resection of all visible foci of disease offers the best control of symptoms. However, the possibility of achieving this goal is limited by the difficulty of detecting all foci and the risks associated with radical surgical strategies. Thus, the excision of ovarian endometrioma can result in a significant impairment of ovarian function, while damage to nerve structures during resection of the uterosacral ligaments, the parametrium, the rectovaginal septum or the vaginal cuff to treat deep infiltrating endometriosis can lead to serious functional impairments such as voiding disorders. A detailed risk-benefit analysis is therefore necessary, and patients must be treated using an individual approach.

Citing Articles

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References

Maytham G, Dowson H, Levy B, Kent A, Rockall T . Laparoscopic excision of rectovaginal endometriosis: report of a prospective study and review of the literature. Colorectal Dis. 2009; 12(11):1105-12. DOI: 10.1111/j.1463-1318.2009.01993.x. View

Koninckx P, Ussia A, Adamyan L, Wattiez A, Donnez J . Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012; 98(3):564-71. DOI: 10.1016/j.fertnstert.2012.07.1061. View

Raffi F, Metwally M, Amer S . The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2012; 97(9):3146-54. DOI: 10.1210/jc.2012-1558. View

Uncu G, Kasapoglu I, Ozerkan K, Seyhan A, Oral Yilmaztepe A, Ata B . Prospective assessment of the impact of endometriomas and their removal on ovarian reserve and determinants of the rate of decline in ovarian reserve. Hum Reprod. 2013; 28(8):2140-5. DOI: 10.1093/humrep/det123. View

Deffieux X, Raibaut P, Hubeaux K, Sheikh Ismael S, Amarenco G . [Voiding dysfunction after surgical resection of deeply infiltrating endometriosis: pathophysiology and management]. Gynecol Obstet Fertil. 2007; 35 Suppl 1:S8-13. View

Borghese B, Santulli P, Streuli I, Lafay-Pillet M, De Ziegler D, Chapron C . [Recurrence of pain after surgery for deeply infiltrating endometriosis: How does it happen? How to manage?]. J Gynecol Obstet Biol Reprod (Paris). 2012; 43(1):12-8. DOI: 10.1016/j.jgyn.2012.11.009. View

Dubuisson J, Pont M, Roy P, Golfier F, Raudrant D . [Female sexuality after surgical treatment of symptomatic deep pelvic endometriosis]. Gynecol Obstet Fertil. 2013; 41(1):38-44. DOI: 10.1016/j.gyobfe.2012.11.010. View

Somigliana E, Benaglia L, Vigano P, Candiani M, Vercellini P, Fedele L . Surgical measures for endometriosis-related infertility: a plea for research. Placenta. 2011; 32 Suppl 3:S238-42. DOI: 10.1016/j.placenta.2011.06.011. View

Dan H, Limin F . Laparoscopic ovarian cystectomy versus fenestration/coagulation or laser vaporization for the treatment of endometriomas: a meta-analysis of randomized controlled trials. Gynecol Obstet Invest. 2013; 76(2):75-82. DOI: 10.1159/000351165. View

10.

Vercellini P, Frattaruolo M, Somigliana E, Jones G, Consonni D, Alberico D . Surgical versus low-dose progestin treatment for endometriosis-associated severe deep dyspareunia II: effect on sexual functioning, psychological status and health-related quality of life. Hum Reprod. 2013; 28(5):1221-30. DOI: 10.1093/humrep/det041. View

11.

Brosens I, Gordts S, Benagiano G . Endometriosis in adolescents is a hidden, progressive and severe disease that deserves attention, not just compassion. Hum Reprod. 2013; 28(8):2026-31. PMC: 3712662. DOI: 10.1093/humrep/det243. View

12.

Ruffo G, Sartori A, Crippa S, Partelli S, Barugola G, Manzoni A . Laparoscopic rectal resection for severe endometriosis of the mid and low rectum: technique and operative results. Surg Endosc. 2011; 26(4):1035-40. DOI: 10.1007/s00464-011-1991-8. View

13.

Roman H, Vassilieff M, Gourcerol G, Savoye G, Leroi A, Marpeau L . Surgical management of deep infiltrating endometriosis of the rectum: pleading for a symptom-guided approach. Hum Reprod. 2010; 26(2):274-81. DOI: 10.1093/humrep/deq332. View

14.

Kovoor E, Nassif J, Miranda-Mendoza I, Wattiez A . Endometriosis of bladder: outcomes after laparoscopic surgery. J Minim Invasive Gynecol. 2010; 17(5):600-4. DOI: 10.1016/j.jmig.2010.05.008. View

15.

Brouwer R, Woods R . Rectal endometriosis: results of radical excision and review of published work. ANZ J Surg. 2007; 77(7):562-71. DOI: 10.1111/j.1445-2197.2007.04153.x. View

16.

Taylor E, Williams C . Surgical treatment of endometriosis: location and patterns of disease at reoperation. Fertil Steril. 2008; 93(1):57-61. DOI: 10.1016/j.fertnstert.2008.09.085. View

17.

Berkes E, Bokor A, Rigo Jr J . [Current treatment of endometriosis with laparoscopic surgery]. Orv Hetil. 2010; 151(28):1137-44. DOI: 10.1556/OH.2010.28904. View

18.

Ferrero S, Venturini P, Gillott D, Remorgida V, Leone Roberti Maggiore U . Hemostasis by bipolar coagulation versus suture after surgical stripping of bilateral ovarian endometriomas: a randomized controlled trial. J Minim Invasive Gynecol. 2012; 19(6):722-30. DOI: 10.1016/j.jmig.2012.08.001. View

19.

Kossi J, Setala M, Makinen J, Harkki P, Luostarinen M . Quality of life and sexual function 1 year after laparoscopic rectosigmoid resection for endometriosis. Colorectal Dis. 2012; 15(1):102-8. DOI: 10.1111/j.1463-1318.2012.03111.x. View

20.

Meuleman C, Tomassetti C, Wolthuis A, Van Cleynenbreugel B, Laenen A, Penninckx F . Clinical outcome after radical excision of moderate-severe endometriosis with or without bowel resection and reanastomosis: a prospective cohort study. Ann Surg. 2013; 259(3):522-31. DOI: 10.1097/SLA.0b013e31828dfc5c. View