DEEP ENDOMETRIOSIS: OVERWIEW OF CURRENT RECOMMENDATIONS AND OWN DATA

VM ZAPOROGAN, IZ GLADCHUK, NM ROZHKOVSKA, K.D. HAIDARZHI
In: Scientific digest of association of obstetricians and gynecologists of Ukraine · 2022 · pp. 26–36 · doi:10.35278/2664-0767.2(50).2023.274979 · W4327800140
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper reviews current recommendations for deep endometriosis management and proposes a standardized surgical procedure to improve excision completeness and patient outcomes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

The paper reviews current recommendations for managing patients with deep endometriosis, focusing on how medical therapy and surgical treatment affect pelvic pain symptoms, quality of life, and fertility outcomes. It describes deep endometriosis as lesions that spread over or under the peritoneum, invade adjacent structures, and are associated with fibrosis and disrupted pelvic anatomy, and it discusses therapeutic goals including hormonal suppression, pro-apoptotic and anti-inflammatory effects on endometriotic tissue, and surgical removal or destruction of lesions and adhesions. The authors propose standardization of the surgical procedure to make the sequence of surgical steps more reproducible while balancing completeness of excision and reducing intra- and postoperative complications, with an aim of preserving fertility. This paper is centrally about endometriosis — specifically deep endometriosis and proposed standardization of its surgical management.

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Abstract

Endometriosis is a chronic inflammatory disease characterized by the presence of endometrial-like tissue outside the uterine cavity. Deep endometriosis is a lesion of the tissue of the abdominal cavity, similar to the endometrium, which spreads on the surface of the peritoneum or under it, is able to penetrate into adjacent structures and is accompanied by fibrosis and a violation of normal anatomy. Treatment of endometriosis includes pain reduction, improvement of fertility due to hormonal suppression of the level of endogenous estrogens, proapoptotic and anti-inflammatory effects on endometrioid tissue, as well as surgical removal or destruction of endometriosis foci and pelvic inflammatory process. But despite numerous studies, the optimal management of patients with deep endometriosis is still the subject of numerous discussions. An analysis of modern recommendations for the management of patients with deep endometriosis, the role of medical and surgical treatment in reducing the symptoms of pelvic pain and improving the fertility and quality of life of patients was carried out. The standardization of the procedure for surgical treatment of deep endometriosis proposed by us will help reproduce the sequence of surgical steps, which will lead to balancing the completeness of excision of tissues affected by endometriosis, and prevention of intra- and postoperative complications, preservation of female fertility.

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endometriosis

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