Diagnostic and treatment guidelines for gastrointestinal and genitourinary endometriosis
Journal Title: UNKNOWN - Year 2017, Vol 18, Issue 4
Abstract
Endometriosis is commonly misdiagnosed, even among many experienced gynecologists. Gastrointestinal and genitourinary endometriosis is particularly difficult to diagnose, and is commonly mistaken for other pathologies, such as irritable bowel syndrome, interstitial cystitis, and even psychological disturbances. This leads to delays in diagnosis, mismanagement, and unnecessary testing. In this review, we will discuss the diagnosis and management of genitourinary and gastrointestinal endometriosis. Medical management may be tried first, but often fails in cases of urinary tract endometriosis. This is particularly important in cases of ureteral endometriosis because silent obstruction can lead to eventual kidney failure. Thus, we recommend complete surgical treatment in these cases. Bladder endometriosis may be managed more conservatively, and only if symptomatic, because these rarely lead to significant morbidity. In cases of bowel endometriosis, we recommend medical management first in all cases, and the least invasive surgical management only if medical treatment fails. This is due to the extensive nervous and vasculature supply to the lower rectum. Injury to these nerves and vessels can cause significant complications and postoperative morbidity.
Authors and Affiliations
Stacy Young, Megan Kennedy Burns, Lucia DiFrancesco, Azadeh Nezhat, Camran Nezhat
Extraperitoneal lymph node dissection in locally advanced cervical cancer; the prognostic factors associated with survival
Objective: Surgical staging was recently recommended for the decision of treatment in locally advanced cervical cancer. We aimed to investigate clinical outcomes as well as factors associated with overall survival (OS) i...
Clinical characteristics and location of lesions in patients with deep infiltrating endometriosis using the revised Enzian classification
Objective: To describe the clinical characteristics and location of lesions in patients with deeply infiltrating endometriosis using the revised Enzian (rEnzian) classification. Material and Methods: The clinical records...
Is there any difference between the distances created by towel clamp lifting and towel clamp plus manual lifting of the anterior abdominal wall for direct trocar entry in laparoscopic gynecologic surgery? A prospective interventional study
Objective Most surgeons prefer to perform anterior abdominal wall lifting during abdominal entry to avoid damage to intestines or main vessels. Anterior abdominal wall lifting is assumed to prevent vital organ injuries b...
Endometriosis: A concise practical guide to current diagnosis and treatment
.
Effects of mature cystic teratoma on reproductive health and malignant transformation: A retrospective analysis of 80 cases
Objective: To examine cases of mature cystic teratoma (MCT) that were diagnosed and treated in our clinic regarding their association with fertility, and to detect the rate of malignant degeneration and the types of mali...