Endometriosis

In: Nezhat's Textbook of Minimally Invasive Surgery · 2025 · pp. 284–357 · doi:10.1017/9781108561440.013 · W4415939518
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This paper reviews the current understanding of endometriosis, a complex gynecological condition characterized by the growth of endometrial-like tissue outside the uterus.

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This chapter/textbook section describes endometriosis at a high level, defining it as ectopic endometrial glands and stroma and summarizing its epidemiology, symptom burden (e.g., dysmenorrhea, dyspareunia, chronic pelvic pain, and/or subfertility), and estimated healthcare and quality-of-life impact. It also discusses proposed explanations for its pathogenesis at a conceptual level, noting that genetic and environmental factors each contribute roughly half of risk, while the exact cause remains unknown. The main limitation is that the provided excerpt is narrative background within a surgery textbook rather than an original study with methods, data, or results. This paper is centrally about endometriosis — it provides a foundational overview (definition, prevalence, burden, and pathogenesis concepts) within Nezhat’s minimally invasive surgery textbook.

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Nezhat's Textbook of Minimally Invasive Surgery Buy print or eBook [Opens in a new window] Including Hysteroscopy, Vaginoscopy and Robotic-Assisted Procedures - Nezhat’s Textbook of Minimally Invasive Surgery - Nezhat’s Textbook of Minimally Invasive Surgery - Copyright page - Dedication - Contents - Online Resources - Contributors - Foreword - Preface - Chapter 1 A History of Modern-Day Video Surgery with and without Robotic Assistance - Chapter 2 Equipment for Operative Laparoscopy and Hysteroscopy - Chapter 3 Anesthesia - Chapter 4 Patient Positioning and Operating Room Setup - Chapter 5 Laparoscopic Access - Chapter 6 Laparoscopic Suturing - Chapter 7 Pelvic Anatomy - Chapter 8 Hysteroscopy - Chapter 9 Fertility - Chapter 10 Management of Adnexal Masses - Chapter 11 Endometriosis - Chapter 12 Video Laparoscopic Adhesiolysis and Adhesion Prevention - Chapter 13 Video Laparoscopic Sterilization - Chapter 14 Leiomyomas - Chapter 15 Hysterectomy - Chapter 16 Pelvic Floor Procedures - Chapter 17 Video Laparoscopy - Chapter 18 Gynecologic Malignancy - Chapter 19 Video Laparoscopic Surgery during Pregnancy - Chapter 20 Pediatric Surgery - Chapter 21 Video Laparoscopic Aortic Surgery - Chapter 22 Additional Procedures for Pelvic Surgeons - Chapter 23 Simulation Training in Minimally Invasive Surgery - Chapter 24 Robotic-Assisted Laparoscopy - Chapter 25 Vascular Surgery and Management of Pelvic Complications - Chapter 26 Fetal Surgery - Chapter 27 Hemostatic Agents in Minimally Invasive Surgery - Chapter 28 New Techniques in Minimally Invasive Surgery - Book part - Index - References Published online by Cambridge University Press: 06 November 2025 Book contents - Nezhat’s Textbook of Minimally Invasive Surgery - Nezhat’s Textbook of Minimally Invasive Surgery - Copyright page - Dedication - Contents - Online Resources - Contributors - Foreword - Preface - Chapter 1 A History of Modern-Day Video Surgery with and without Robotic Assistance - Chapter 2 Equipment for Operative Laparoscopy and Hysteroscopy - Chapter 3 Anesthesia - Chapter 4 Patient Positioning and Operating Room Setup - Chapter 5 Laparoscopic Access - Chapter 6 Laparoscopic Suturing - Chapter 7 Pelvic Anatomy - Chapter 8 Hysteroscopy - Chapter 9 Fertility - Chapter 10 Management of Adnexal Masses - Chapter 11 Endometriosis - Chapter 12 Video Laparoscopic Adhesiolysis and Adhesion Prevention - Chapter 13 Video Laparoscopic Sterilization - Chapter 14 Leiomyomas - Chapter 15 Hysterectomy - Chapter 16 Pelvic Floor Procedures - Chapter 17 Video Laparoscopy - Chapter 18 Gynecologic Malignancy - Chapter 19 Video Laparoscopic Surgery during Pregnancy - Chapter 20 Pediatric Surgery - Chapter 21 Video Laparoscopic Aortic Surgery - Chapter 22 Additional Procedures for Pelvic Surgeons - Chapter 23 Simulation Training in Minimally Invasive Surgery - Chapter 24 Robotic-Assisted Laparoscopy - Chapter 25 Vascular Surgery and Management of Pelvic Complications - Chapter 26 Fetal Surgery - Chapter 27 Hemostatic Agents in Minimally Invasive Surgery - Chapter 28 New Techniques in Minimally Invasive Surgery - Book part - Index - References Endometriosis is classically defined as the presence of endometrial glands and stroma in ectopic locations. Affecting 6–10% of reproductive-aged women, endometriosis can result in dysmenorrhea, dyspareunia, chronic pelvic pain, and/or subfertility.[1,2] The prevalence of this condition in women experiencing pain, infertility, or both is as high as 50%. Endometriosis is a debilitating condition, posing quality-of-life (QOL) issues for the individual patient.[3] The disorder represents a major cause of gynecologic hospitalization in the US, estimated to have exceeded $69 billion in healthcare costs for diagnosis and treatment and improving QOL in 2009.[4] The significant individual and public health concerns associated with endometriosis underscore the importance of understanding its pathogenesis. The first recorded description of pathology consistent with endometriosis was provided by Shroen in 1690.[5] Despite the passage of time and extensive investigation, the exact pathogenesis of this enigmatic disorder remains unknown, although about 50% of risk of developing endometriosis is due to genetic factors and 50% to environmental factors. - Type - Chapter - Information - Nezhat's Textbook of Minimally Invasive SurgeryIncluding Hysteroscopy, Vaginoscopy and Robotic-Assisted Procedures, pp. 284 - 357Publisher: Cambridge University PressPrint publication year: 2025 Giudice, LC. Clinical practice. Endometriosis. New Engl J Med 2010;362(25):2389–2398.10.1056/NEJMcp1000274CrossRefGoogle ScholarPubMed Eskenazi, B, Warner, ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am 1997;24(2):235–258.10.1016/S0889-8545(05)70302-8CrossRefGoogle ScholarPubMed Nnoaham, KE, Hummelshoj, L, Webster, P, et al. 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