Surgical management of deeply infiltrating endometriosis: an update
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This paper updates surgical management strategies for deeply infiltrating endometriosis, emphasizing complete exeresis guided by lesion mapping and proposing a surgical classification for standardized treatment.
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Abstract
Deeply infiltrating endometriosis (DIE) manifests itself mainly in the form of pain, predominantly deep dyspareunia, and painful functional symptoms that are aggravated monthly during menstruation, with the semiology being directly correlated with the location of the lesions (bladder, rectum). A workup to assess the extent of the disease is necessary to establish an accurate map of the DIE lesions, which is the essential condition to perform complete exeresis. The treatment of first intention is surgical, because medical treatments are only palliative in the majority of cases. Successful treatment depends on achieving radical surgical exeresis. Analysis of the anatomical distribution of the DIE lesions allows a "surgical classification" to be proposed to standardize the modalities of surgical treatment. Further studies are needed to specify the place and modalities of medical treatments preoperatively and postoperatively.
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- Endometriosis-Associated Infertility: A Review of Pathophysiological Mechanisms and Current Treatment Strategies 2026
- Adenomyosis and endometriosis in adolescents and young women with pelvic pain: prevalence and risk factors 2024
- Evaluating the safety of high-intensity focused ultrasound treatment for rectal endometriosis: results from a French prospective multicentre study including 60 patients 2024
- Evidence for Surgery for Pelvic Pain 2021
- Tratamiento quirúrgico de la endometriosis pélvica profunda con compromiso colorrectal 2019
- Endometriosis and Sexuality 2017
- Pelvic examination may be meaningfully taught to novices and be used to predict operating times for laparoscopic excision of endometriosis in one surgical procedure 2017
- Rectovaginal endometriosis : pain treatment options 2016
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