Endometriosis

In: The ASCRS Textbook of Colon and Rectal Surgery · 2021 · pp. 715–728 · doi:10.1007/978-3-030-66049-9_41 · W4200503290
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Endometriosis is a chronic disease causing pain and infertility, diagnosed via laparoscopy, with surgical excision of lesions being the standard treatment.

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This chapter reviews endometriosis as a chronic gynecologic disease causing severe pelvic pain, infertility, and intestinal dysmotility, focusing on diagnostic and treatment approaches. It discusses high-level methods such as using laparoscopy as the diagnostic modality of choice due to limitations of noninvasive tests’ sensitivity and specificity, and describes management as medical therapy reserved for early-stage disease and surgery with excision as the current standard. It highlights that deeply infiltrative lesions in the rectovaginal septum often require coordinated colorectal and gynecologic surgical involvement, with a noted caveat of common diagnostic and treatment delays. This paper is centrally about endometriosis — it is a clinical-surgical overview emphasizing diagnosis (laparoscopy) and operative management of deeply infiltrative disease.

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Abstract

Endometriosis is a chronic, debilitating disease in women present during the most productive period of their lives. It causes severe pelvic pain, infertility, and intestinal dysmotility. Laparoscopy is the diagnostic modality of choice because a noninvasive alternative is not sensitive or specific. Delays in diagnosis and treatment are common. Medical management is reserved for early-stage disease. Surgery with excision of the nodules of endometriosis is the current standard. Colon and rectal surgeons become involved in resecting the deeply infiltrative lesions in the rectovaginal septum usually in partnership with a gynecologist removing the ovarian endometriomas and other pelvic peritoneal disease. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Nnoaham KE, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multi center study across ten countries. Fertil Steril. 2011;96:366–73. Hudelist G, Fritzer N, Thomas A, et al. Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod. 2012;27:3412–6. Adamson GD, Kennedy S, Hummelshoj L. Creating solutions in endometriosis: global collaboration through the world Endometriosis Research Foundation. J Endometriosis. 2010;2:3–6. Soliman AM, Surrey E, Bonafede M, et al. Real world evaluation of direct and indirect economic burden among endometriosis patients in the United States. Adv Ther. 2018;35:408–23. Shafrir A, Farland L, Shah D, et al. Risk for and consequence of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obste Gynaecol. 2018;51:1–15. American Colleg of Obstetricians and Gynecology. Management of endometriosis. ACOG Practice bulletin no. 114. Obste Gynecol. 2010;116:225–36. Houston DE, Noller KL, Melton J III, Selwyn BJ. The epidemiology of pelvic endometriosis. Clin Obstet Gynecol. 1988;31(4):787–800. Soliman AM, Yang H, Du EX, et al. The direct and indirect costs associated with endometriosis: a systematic literature review. Hum Reprod. 2016;31:712–22. Kjerulff KH, Erickson BA, Langenberg PW. Chronic gynecological conditions reported by US women: findings from the National Health Information Survey, 1984 to 1992. Am J Public Health. 1996;86:195. Halme J, Stovall D. Endometriosis and its medical management. In: Walch EE, Zacur HA, editors. Reproductive medicine and surgery. St. Louis: Mosby; 1995. p. 695–710. Moen MH. Is a long period without childbirth a risk factor for endometriosis? Hum Reprod. 1991;6:1404–7. D’Hooghe TM, Bambra CS, Raeymaekers BM, et al. Serial laparoscopies over 30 months show that endometriosis in captive baboons (Papio Anubis, Papio cyancephalus) is a progressive disease. Feril Steril. 1996;65:645–9. Miyazawa K. Incidence of endometriosis among Japanese women. Obstet Gynecol. 1976;48:407–9. Taylor HS, Adamson GD, Diamond MP, et al. An evidence –based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis. Int J Gynaecol Obstet. 2018;142:131–42. Weitraub A, Soriano D, Seidman D, et al. Think endometriosis: delay in diagnosis or delay in referral to adequate treatment. J Fertil In Vitro IVF Worldw Reprod Med Genet Stem cell Biol. 2014;2:127. Quibel A, Puscasiu L, Marpeau L, et al. General practitioners and the challenge of endometriosis screening and care: results of a survey. Gynecol Obstet Fertil. 2013;41:372–80. Ridley JH. The histogenesis of endometriosis. A review of facts and fancies. Obstet Gynecol Surv. 1968;20:1–35. Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary, their importance and especially their relation to pelvic adenomas of endometrial type. Arch Surg. 1921;3:245–323. Telinde RW, Scott RB. Experimental endometriosis. Am J Obstet Gynecol. 1950;60:1147–73. Ridley JH, Edwards KI. Experimental endometriosis in the human. Am J Obstet Gynecol. 1958;76:783–90. Simpson JL, Elias S, Malinak LR, Buttram VC. Heritable aspects of endometriosis. 1. Genetic studies. Am J Obstet Gynecol. 1980;137:327–31. Dmowski WP, Steele RW, Baker GF. Deficient cellular immunity in endometriosis. Am J Obstet Gynecol. 1981;141:377–83. Vigano P, Vercellini P, DiBlasio AM, et al. Deficient anti-endometrium lymphocyte mediated cytotoxicity in patients with endometriosis. Fertil Steril. 1991;56:894–9. Oosterlynck DJ, Cornillie FJ, Waer M, et al. Women with endometriosis show a defect in natural killer activity resulting in a decreased cytotoxicity to autologous endometrium. Fertil Steril. 1991;56:45–51. Johnson NP, Hummelshoj L. Consensus on current management of endometriosis. Hum Reprod. 2013;28:1552–68. Fauconnier A, Chapron C, Dubuisson JB, et al. Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril. 2002;78:719–26. Muse K. MD. Clinical manifestations and classification of endometriosis. Clin Obstet Gynecol. 1988;31(4):813–22. Peterson, et al. Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study. Am J Obstet Gynecol. 2013;208(6):451.e1–11. Hemmings, et al. Evaluation of risk factors associated with endometriosis. Fertil Steril. 2004;81(6):1513–21. Wahid B, et al. Biomarkers of diagnosis of pre-eclampsia and endometriosis. Biomark Med. 2018;12(10):1161–73. Koninkx PR, Martin D. Treatment of deeply infiltrating endometriosis. Curr Opin Obstet Gynecol. 1994;6:231–41. Chen, et al. Accuracy of physical examination, transvaginal sonography, magnetic resonance imaging, and rectal disc optic sonography for preoperative evaluation of rectovaginal endometriosis. Ultrasound Quart. 2019;35(1):54–60. Reid S, Condous G. Transvaginal sonographic sliding sign: accurate prediction of pouch of Douglas obliteration. Ultrasound Obstet Gynecol. 2013;41:605–7. Arion, et al. Prediction of pouch of douglas obliteration: point of care ultrasound versus pelvic examination. J Minim Invasive Gynecol. 2019;26(5):928–34. Leonardi M, et al. Deep endometriosis: a diagnostic dilemma with significant surgical consequences. J Obstet Gynecol Can. 2018;40(9):1198–203. Milone V, et al. Role of colonoscopy in the diagnostic workup endometriosis. World J Gastroenterol. 2015;21(16):4997–5001. Chen H, et al. Case Report: Rectal Mucosa endometriosis primarily misinterpreted as adenocarcinoma: a case report and review of the literature. Int Journal Exp Pathol. 2015;8(5):5902–7. Jiang W, et al. Endometriosis involving the mucosa of the intestinal tract: a clinicopathologic study of 15 cases. Mod Pathol. 2013;26:1270–8. Ma, et al. Can narrowband imaging improve the laparoscopic identification of superficial endometriosis? A prospective cohort trial. J Minim Invasive Gynecol. 2019;26(3):427–33. Barrueto F, Audlin K. The use of narrow band imaging for identification of endometriosis. J Minim Invasive Gynecol. 2008;15(5):36–639. Tinneberg HR, et al. Classification of Endometriosis Chapter 21. In: Harada T, editor. Endometriosis: Pathogenesis and Treatment: Springer; 2014. p. 341–62. Johnson NP, et al. World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod. 2017;32(2):315–24. Barreta A, et al. Endometriosis -Associated Ovarian Cancer. Population characteristic and prognosis. Int J Gynecol Cancer. 2018;28(7):1251–7. Saavalainen L, et al. Risk of Gynecological Cancer According to the type of endometriosis. Obstet Gynecol. 2018;131(6):1095–102. Rafique S, Decherney AH. Medical management of endometriosis. Clinical obstetrics and gynecology, September. 2017;60(3):485–96. Chapron, et al. Management of Ovarian Endometriomas. Hum Reprod Update. 2002;8(6):91–7. Hidari T, et al. Contralateral ovarian endometrioma recurrence after unilateral salpingo-oophorectomy. BMC Womens Health. 2019;19:59. Almeida A, et al. Disc resection is the first option in the management of rectal endometriosis for unifocal lesions with less than 3 centimeters of longitudinal diameter. Surg Technol Int. 24:243–8. Abrao MS, et al. Endometriosis lesions that compromise the rectum deeper than the inner muscular layer have more than 40% of the circumference of the rectum affected by the disease. J Minim Invasive Gynecol. 2008;15(3):280–5. Angioli, et al. Surgical treatment of rectovaginal endometriosis with extensive vaginal infiltration: results of a systemic three-step vagino-laparoscopic approach. Euro J Obstet Gynecol Reprod Biol. 2014;173:83–7. Minelli, et al. Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications. Fertil Steril. 2010;94:1218–22. Keckstein, et al. Deep endometriosis, including intestinal involvement – the interdisciplinary approach. Minn Invasive Ther Allied Technol. 2005;14:160–6. Ruffo, et al. Laparoscopic colorectal resection for deep infiltrating endometriosis: analysis of 436 cases. Surg Endosc. 2010;24:63–7. Lermann, et al. Comparison of preoperative and postoperative sexual function in patients with deeply infiltrating endometriosis with and without bowel resection. Europ J Obstet Gynecol Reprod Biol. 2019;239:21–9. Meuleman, et al. Clinical outcomes after radical excision of moderate to severe endometriosis with without bowel resection and reanastomosis; a prospective cohort study. Ann Surg. 2014;259(3):522–31. Abo, et al. Postoperative complications after bowel endometriosis surgery by shaving, disc excision or segmental resection: A three arm comparative analysis of 364 consecutive cases. Fertil Steril. 2018;109(1):172–8. Bertocchi V, et al. Colorectal anastomotic stenosis: lessons learned after 1643 colorectal resections for deep infiltrating endometriosis. J Minim Invasive Gynecol. 2019;26:100–4. Donnez O, Roma H. Choosing the right surgical technique for deep endometriosis: shaving, disc excision or bowel resection? Fertil Steril. 2017;108(6):931–42. Vignali M, et al. Surgical treatment of deep endometriosis and risk of recurrence. J Minim Invasive Gynecol. 2005;12(6):508–13. Bozdag G. Recurrence of endometriosis: risk factors, mechanisms and biomarkers. Special report. Women Health. 2015;11(5):693–9. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2022 Springer Nature Switzerland AG About this chapter Cite this chapter Chua, H., Snyder, M.J. (2022). Endometriosis. In: Steele, S.R., Hull, T.L., Hyman, N., Maykel, J.A., Read, T.E., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-66049-9_41 Download citation DOI: https://doi.org/10.1007/978-3-030-66049-9_41 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-66048-2 Online ISBN: 978-3-030-66049-9 eBook Packages: MedicineMedicine (R0)

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