Laparoscopic management of the advanced and rectovaginal endometriosis with gastrointestinal involvement: A review of the current literature

In: Cumhuriyet Medical Journal · 2014 · vol. 36(2) , pp. 281–287 · doi:10.7197/1305-0028.2531 · W4249907697
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This review examines laparoscopic management for advanced rectovaginal endometriosis with gastrointestinal involvement, finding that conservative "shaving" is preferred over bowel resection for patients without obstruction or mucosal bleeding.

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Abstract

Endometriosis is the presence of endometrial gland and stromal tissue outside the uterus with a potentially invasive nature despite being a benign disease process.The exact prevalence of the disease is not known but 10-15% of reproductive age women are affected.The peritoneal and rectovaginal endometriosis are two distinct entities of the disease with different symptoms and treatment strategies.Dyschezia and deep dyspareunia with nodularity on sacrouterine ligaments during rectovaginal examination are specific symptoms of deeply infiltrating endometriosis (DIE).Rectovaginal or bowel involvement is estimated to be present in 5 to 12 percent of women with endometriosis and the most common site is the rectosigmoid colon.Medical treatment of DIE with colorectal involvement results with symptomatic relief without any curative effect on endometriotic foci.Colorectal endometriosis treatment is a major challenge for the clinicians when incidentally encountered during a diagnostic laparoscopy.As randomised controlled studies comparing medical with surgical treatment for rectovaginal or bowel endometriosis are lacking; the impact of the surgical treatment modalities on clinical improvement of the symptoms, complications, recurrence and pregnancy rates is not known.Current literature indicates that, patients without bowel occlusion and/ or rectal bleeding with mucosal involvement caused by DIE should be treated with conservative technique specifically described as "shaving" method that have lower complication and recurrence rates than the invasive technique including bowel resection and anastomosis.

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Condition tags

endometriosisdie_deep_infiltratingbowel_endometriosisdyspareunia

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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