Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution

Chapron, Charles; Chopin, Nicolás; Borghese, Bruno; Foulot, H.; Dousset, B.; Vacher-Lavenu, M. C.; Vieira, Marco; Hasan, Wael; Bricou, Alexandre

doi:10.1093/humrep/del079

Cited by 385 publications

(262 citation statements)

References 55 publications

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“…Deep endometriosis is the more aggressive form of this disease and it infiltrates the retrocervical area, posterior vaginal wall, rectosigmoid regions, ureters and bladder to a depth of more than 5 mm and may even involve pelvic lymph nodes 2,3 .…”

Section: Introductionmentioning

confidence: 99%

Th1 and Th2 immune responses related to pelvic endometriosis

Podgaec¹,

Dias²,

Chapron³

et al. 2010

Rev. Assoc. Med. Bras.

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Section: Introductionmentioning

confidence: 99%

Th1 and Th2 immune responses related to pelvic endometriosis

Podgaec¹,

Dias²,

Chapron³

et al. 2010

Rev. Assoc. Med. Bras.

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“…Among women with a surgically proven diagnosis of endometriosis, the reported prevalence of rectovaginal or bowel involvement ranges from 5 to 25 percent [11]. In a recent observational study including 426 patients with 172 intestinal DIE lesions, the rectum and rectosigmoid colon, sigmoid colon, caecum and ileocaecal jnction, appendix, small bowel and omentum were involved in 65.7%, 17.4%, 4.1%, 6.4%, 4.7% and 1.7% respectively [12]. Pelvic DIE lesions are more frequently observed in the posterior region of the pelvis and are most often located on the left side unlike abdominal DIE lesions which are most often located in the right side of the abdominal cavity (appendix and ileocaecum junction).…”

Section: Gastrointestinal Involvement Sites Of the Diseasementioning

confidence: 99%

Laparoscopic management of the advanced and rectovaginal endometriosis with gastrointestinal involvement: A review of the current literature

Kahyaoğlu

2014

Cumhuriyet Med J

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Endometriosis is the presence of endometrial gland and stromal tissue outside the uterus with a potentially invasive nature despite being a benign disease process. The exact prevalence of the disease is not known but 10-15% of reproductive age women are affected. The peritoneal and rectovaginal endometriosis are two distinct entities of the disease with different symptoms and treatment strategies. Dyschezia and deep dyspareunia with nodularity on sacrouterine ligaments during rectovaginal examination are specific symptoms of deeply infiltrating endometriosis (DIE). Rectovaginal or bowel involvement is estimated to be present in 5 to 12 percent of women with endometriosis and the most common site is the rectosigmoid colon. Medical treatment of DIE with colorectal involvement results with symptomatic relief without any curative effect on endometriotic foci. Colorectal endometriosis treatment is a major challenge for the clinicians when incidentally encountered during a diagnostic laparoscopy. As randomised controlled studies comparing medical with surgical treatment for rectovaginal or bowel endometriosis are lacking; the impact of the surgical treatment modalities on clinical improvement of the symptoms, complications, recurrence and pregnancy rates is not known. Current literature indicates that, patients without bowel occlusion and/ or rectal bleeding with mucosal involvement caused by DIE should be treated with conservative technique specifically described as "shaving" method that have lower complication and recurrence rates than the invasive technique including bowel resection and anastomosis.Keywords: Laparoscopy, gastrointestinal, rectovaginal, bowel endometriosis, surgical treatment ÖzetEndometriozis iyi huylu bir hastalık prosesi olmasına rağmen endometrial gland ve stromanın uterus dışında potansiyel olarak invazif bir davranışla bulunmasıdır. Hastalığın kesin prevelansı bilinmemektedir fakat üreme çaındaki kadınların yaklaşık %10-15'i etkilenmiştir. Peritoneal ve rektovajinal endometriozis hastalığın farklı semptom ve tedavi stratejileri olan iki ayrı antitesidir. Rektovajinal muayene sırasında sakrouterin ligamentlerde nodülarite ile beraber diskezi ve derin disparanü derin infiltratif endometriozisin (DİE) spesifik semptomlarıdır. Endometriozisli hastaların yaklaşık %5-12'sinde rektovajinal veya barsak tutulumu mevcut olduğu tahmin edilmektedir ve en sık tutulan bölge rektosigmoid kolondur. Kolorektal tutumlu DİE'nin tıbbi tedavisi endometriotik odaklar üzerinde herhangi bir küratif etki etmeden semptomatik rahatlama sağlar. Tanısal bir laparoskopi sırasında tesadüfen saptandığında kolorektal endometriozis tedavisi klinisyenler için major bir sorundur. Rektovajinal veya barsak endometriozisinin medikal ve cerrahi tedavisini birbiri ile karşılaştıran randomize kontrollü çalışmalar olmadığı için cerrahi tedavi modalitelerinin semptomlarda klinik düzelme, komplikasyonlar, rekürrens ve gebelik oranları üzerine etkisi bilinememektedir. Güncel literatüre göre, barsak oklüzyonu ve/ veya rektal kanama...

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“…Although there is a classification of the stages of endometriosis by the American Fertility Society, this classification is seen as helpful in the area of fertility but of a lesser benefit to pain considerations 39;40 . More recently the disease is classified with respect to four categories: peritoneal in location, nodular and invasive, ovarian endometriomas and uterine adenomyosis [41][42][43][44] . This latter condition represents a developmental abnormality in which the abnormal endometrial location is within the actual wall of the uterus.…”

Section: Laparoscopy For Endometriosismentioning

confidence: 99%

Myofascial Dysfunction and Its Relationship to Laparoscopy

Jarrell¹

2011

Advanced Gynecologic Endoscopy

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Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution

Cited by 385 publications

References 55 publications

Th1 and Th2 immune responses related to pelvic endometriosis

Th1 and Th2 immune responses related to pelvic endometriosis

Laparoscopic management of the advanced and rectovaginal endometriosis with gastrointestinal involvement: A review of the current literature

Myofascial Dysfunction and Its Relationship to Laparoscopy

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