{"paper_id":"3effb14b-0465-439d-8685-914538f9b44b","body_text":"Abstract\nEndocrine pharmacotherapy can be used as a neo-adjuvant or adjuvant measure; however, in the majority of symptomatic cases, surgical resection is the treatment of choice for deeply infiltrating endometriosis, to improve pain, quality of life, and possibly fertility.\nThe goal should be to achieve the complete treatment of all endometriotic lesions by a single operation. Since more complex cases require resection of the intestinal wall and/or bladder or ureter, the expertise and cooperation of different specialists, namely colorectal and urologic surgeons, is warranted.\nMany retrospective studies have demonstrated the beneficial effect of conservative surgery for pain symptoms; however, few studies have reported long-term follow-up data\nIn the case of rectal or rectosigmoid involvement, a formal bowel resection, rather than partial excision, is most often preferable, despite the fact that it entails a higher risk of intraoperative and postoperative complications. In cases of bladder endometriosis, transurethral resection, partial cystectomy, or combined operations can be performed, whereas, when the ureter is involved, ureterolysis, ureterostomy, and ureteral reimplantation are carried out.\nLaparoscopic and laparotomic resections achieve the same results in terms of symptom control, although the complexity of the disease or extensive involvement of extragenital organs sometimes requires laparotomy, or carries a high risk of conversion.\nData on reoperation for rectovaginal endometriosis and repetitive conservative surgery are scant.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nPreview\nUnable to display preview. Download preview PDF.\nSimilar content being viewed by others\nReferences\nMechsner S, Bartley J, Loddenkemper C et al. Oxytocin receptor expression in smooth muscle cells of peritoneal endometriotic lesions and ovarian endometriotic cysts. 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Am J Obstet Gynecol 2005; 193:114–117\nAuthor information\nAuthors and Affiliations\nRights and permissions\nCopyright information\n© 2011 Springer-Verlag Italia\nAbout this chapter\nCite this chapter\nDe Nardi, P., Ferrari, S. (2011). Treatment. In: Deep Pelvic Endometriosis. Springer, Milano. https://doi.org/10.1007/978-88-470-1866-2_3\nDownload citation\nDOI: https://doi.org/10.1007/978-88-470-1866-2_3\nPublisher Name: Springer, Milano\nPrint ISBN: 978-88-470-1865-5\nOnline ISBN: 978-88-470-1866-2\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}