Voiding dysfunction after complex deep endometriosis surgery is probably one of the less recognised complications of this type of surgery. Certain locations of deep endometriosis (eg. Parametrium, uterosacral ligaments, sacral plexus), when excised, may be linked to higher risk of voiding dysfunction post-operatively. This may be due to inadvertent injury to the innervation of the bladder during surgical excision…
Endometriosis is a common, benign gynecological disease that is usually associated with pain and/or infertility. It appears likely that chronic inflammation, that is typical of endometriosis lesions, plays a role in chronic pain as well as infertility. It is, therefore, logical to ask if there is a possible link between the severity of endometriosis symptoms and the outcomes of artificial…
It is not uncommon that patients suffering from endometriosis are advised by their doctor to get pregnant in order to ‘’cure’’ (or at least manage the symptoms of) endometriosis. Pregnancy itself is not a cure for endometriosis, however, we often neglect the impact this advice may have on the patients’ mental health and overall experience. Discussing conception is a…
According to a new study, patients operated for recurrent endometrioma had more deep endometriosis lesions and more severe disease, compared to those with no previous endometrioma surgery.
The most comprehensive study on the risk of repeat surgery for endometriosis was only recently published, suggesting a risk of up to 28% during the first 10 years after complete excision of endometriosis. What is also interesting is that performing a hysterectomy at the time of first surgery, as well as achieving a post-operative pregnancy, were found to be independent, protective factors against repeat surgery. The mean time between primary and repeat surgery in this study was 46 months (1).
Vitamin D is a steroid hormone produced mostly as a result of exposure to UV light and regulates the levels of calcium and phosphate in the blood (1). Except its role in bone health, studies have demonstrated its role in human reproduction, with 15% of subfertile couples having low vitamin D levels (2), as well in regulation of inflammation,…
Deep endometriosis is considered the most severe form of endometriosis. It is commonly associated with severe pelvic pain and infertility. As regards the latter, severe distortion of the pelvic anatomy due to adhesions and chronic inflammation are key mechanisms. Other than primary IVF, deep endometriosis surgery is a useful tool, as it can increase chances of spontaneous conception in appropriately…
Endometrioma (or chocolate cyst of the ovary) is estimated to affect 17-44% of women suffering from endometriosis (1). Its presence is often associated with infertility and/ or chronic pelvic pain and its surgical management may be indicated. What are the available methods of surgical management of endometrioma and what outcomes are they linked with? In this article, we…
Endometrioma is a type of ovarian cyst that develops secondary to the presence of endometriosis. It is, also, called ‘’chocolate cyst’’ due to the characteristic colour of the fluid it contains. 17% to 44% of women with endometriosis have an endometrioma (1), of which, in 19% to 28% of cases, the endometrioma is bilateral (2). The exact cause, as…
We know that endometriosis is associated with infertility and, in patients with deep infiltrating endometriosis (DIE), spontaneous pregnancy rate (without the use of assisted reproduction technologies) is estimated to be around 2 and 10% (1). Although these patients often end up using assisted reproduction in order to get pregnant, can surgical management of endometriosis increase the chances of conception? …
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