Composite Pelvic Resection for Deeply Infiltrating Endometriosis

In: Major Complications of Female Pelvic Surgery · 2025 · pp. 255–264 · doi:10.1007/978-3-031-66772-5_24 · W4408279237
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This paper discusses the definition, diagnosis, and surgical treatment of deep infiltrating endometriosis, including techniques for bowel and urologic involvement.

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This chapter reviews deep infiltrating endometriosis, including its proposed multifactorial pathophysiology, variable symptom presentation, and the approach to diagnosis and treatment at a high level. It outlines nonsurgical management options such as NSAIDs and hormonal suppression (progestins, GnRH agonists, and antagonists) and describes surgical management that centers on excision, noting differing techniques for bowel and urologic disease. A major limitation is that the text is largely narrative/overview-based rather than presenting new empirical results or a specific study population. This paper is centrally about endometriosis — it focuses on management and surgical considerations for deeply infiltrating endometriosis, including composite pelvic resection concepts.

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Abstract

Endometriosis is a chronic gynecologic condition associated with chronic pelvic pain and infertility. It is characterized by endometrial tissue outside the uterus, which can invade various organs and structures. Its pathophysiology is still under investigation, although it is likely secondary to a combination of retrograde menstruation, immune dysfunction, and coelomic metaplasia, amongst other contributing factors. Endometriosis may be difficult to diagnose as symptoms vary per individual. Common clinical presentations include pelvic pain, dysmenorrhea, dyspareunia, and infertility. Treatment depends on the patient’s symptoms and goals. Patients can opt for expectant management if asymptomatic. Nonsurgical options include a combination of nonsteroidal anti-inflammatory drugs and hormonal suppression via progestins, gonadotropin-releasing hormone agonists, or gonadotropin-releasing hormone antagonists. Surgical management involves excision. There are different techniques for excision of bowel and urologic endometriosis. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Springer, Cham. https://doi.org/10.1007/978-3-031-66772-5_24 Download citation DOI: https://doi.org/10.1007/978-3-031-66772-5_24 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-031-66771-8 Online ISBN: 978-3-031-66772-5 eBook Packages: MedicineMedicine (R0)

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