Treatment

Endocrine 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. The 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. Many retrospective studies have demonstrated the beneficial effect of conservative surgery for pain symptoms; however, few studies have reported long-term follow-up data In 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. Laparoscopic 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. Data on reoperation for rectovaginal endometriosis and repetitive conservative surgery are scant. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

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Am J Obstet Gynecol 2005; 193:114–117 Author information Authors and Affiliations Rights and permissions Copyright information © 2011 Springer-Verlag Italia About this chapter Cite this chapter De Nardi, P., Ferrari, S. (2011). Treatment. In: Deep Pelvic Endometriosis. Springer, Milano. https://doi.org/10.1007/978-88-470-1866-2_3 Download citation DOI: https://doi.org/10.1007/978-88-470-1866-2_3 Publisher Name: Springer, Milano Print ISBN: 978-88-470-1865-5 Online ISBN: 978-88-470-1866-2 eBook Packages: MedicineMedicine (R0)