Endometriosis infiltrante: revisión de tema Deep endometriosis: a review

Adriana Arango Martínez
In: CES Medicina · 2009 · vol. 23(1) , pp. 47–60 · W2100561695
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This review defines deep endometriosis, discusses its symptoms, diagnostic approaches, and treatment options including surgery and pharmacotherapy, emphasizing multidisciplinary management.

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Abstract

La endometriosis infiltrante o profunda se define como la presencia de lesiones endometriales que infiltran el tejido mas de 5mm, se ubican en el retroperitoneo en sitios diferentes a la endometriosis comun y comprometen diferentes estructuras u organos como intestino, ureter. vejiga, ligamentos utero sacros y region rectovaginal, pudiendo alterar la calidad de vida de la mujer. Los sintomas mas frecuentes incluyen la dismenorrea, la dispareunia y la disquexia. Una aproximacion al diagnostico incluye la historia clinica con enfasis en los sintomas dolorosos de la endometriosis profunda, el examen fisico con evaluacion de la pelvis y las ayudas diagnosticas que dependen del sistema comprometido y que van desde la eco transvaginal, ecotransrectal y/o resonancia magnetica, hasta el colon por enema con doble contraste y la urografia excretora o el urotac. La cirugia es la opcion mas efectiva para el tratamiento en el tiempo dependiendo del sitio de ubicacion y el compromiso de los diferentes organos; sin embargo, el tratamiento farmacologico es una conducta vigente y con indicaciones precisas que pudiera ser la opcion principal o complementaria, a pesar de la recurrencias de los sintomas o de las lesiones. Dado que la endometriosis infiltran te o profunda es una enfermedad multisistemica, debe ser manejada por un equipo multidisciplinario. ABSTRACT This paper is a review of infiltrating or deep endometriosis and includes the definition, clinic, diagnostic tools and different options of medical and surgical treatment. Deep endometriosis is defined as the presence of endometrial injuries that infiltrate the tissue in more than 5mm. are located in the retro~peritoneum in different places than the common endometriosis which jeopardize different structures and organs such as: intestine. ureter. bladder. uterosacral ligaments and the rectovaginal area. being able to alter the woman's quality of life. The most frequent symptoms include dysmenorrhoea. dyspareunia and dysquexia. An approach to the diagnosis includes a good clinical history with emphasis in the painful symptoms. physical examination with pelvis evaluation and the diagnostic tools that depend on the jeopardized system and includes transvaginal ultrasound, transrectal ultrasound and/or magnetic resonance, colon by enema with double contrast and the excretory urography or urotae. Surgery is the most effective option for the treatment at this time. depending on the location and the involvement of the different organs; nevertheless, pharmacological treatment with precise indications is a valid conduct and could be the main or a complementary option, in spite of the recurrences of symptoms or injuries. Since the infiltrating or deep endometriosis is a multi-systemic disease. it must be handled by a multidisciplinary team.

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Condition tags

endometriosisdysmenorrheadyspareunia

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