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…
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).
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? …
Endometriosis of the gastrointestinal system accounts for 5 to 12% of deep endometriosis cases1. 90% infiltrates the rectum and the sigmoid (large bowel)2. In most cases, the patients present with severe symptoms, such as the following: dyschezia (pain on opening the bowels), haematochezia (blood in the stools), bloating and change between constipation and diarrhoea. Those symptoms are, often, more intense…
The urinary tract is infiltrated in 14-20% of patients with deep infiltrating endometriosis1. They often coexist with other endometriosis lesions. The most common symptoms are frequent urination, pain and burning on urination, strong desire to pass urine, blood in the urine and inability to fully empty the bladder. Some patients may have no symptoms at all. Diagnosis can be achieved…
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