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Download Deep Pelvic Endometriosis: A Multidisciplinary Approach by Paola De Nardi, Stefano Ferrrari, Elaine Denny PDF

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By Paola De Nardi, Stefano Ferrrari, Elaine Denny

Deep pelvic endometriosis is likely one of the such a lot serious expressions of a affliction which may contain all of the pelvic organs – bladder, ureters, rectosigmoid colon – inflicting debilitating signs and resulting in impaired caliber of existence in younger women.
The chapters conceal either diagnostic and healing points of this illness. The relevant position of diagnostic imaging in surgical choice making is highlighted, in addition to the problems desirous about cautious making plans of surgical operation, and unique awareness is paid to minimally invasive techniques.
The paramount significance of a multidisciplinary workforce, related to the services of radiologists, gastroenterologists, and psychologists, in addition to the talents of the gynecologist, urologist, and colorectal health practitioner is underlined through the text.

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Correlation between endometriosis and pelvic pain. J Am Assoc Gynecol Laparosc 1999;6:429–434 Koninckx PR, Meuleman C, Demeyere S et al. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 1991;55:759–765 Chapron C, Barakat H, Fritel X et al. Presurgical diagnosis of posterior deep infiltrating endometriosis based on a standardized questionnaire. Hum Reprod 2005;20:507–513 Berkley KJ, Dmitrieva N, Curtis KS, Papka RE.

In a small number of these patients, the presence of a renal colic will lead to prompt diagnosis and thus to an earlier treatment. 5%) in patients with known pelvic endometriosis seems to warrant the need for further investiga- 2 Diagnosis 21 tions regarding the possibility of avoiding the high percentage of silent renal losses [17]. The loss of renal units in patients with ureteral endometriosis causing hydronephrosis has been estimated to be 25–50% at the time of diagnosis, although these data derive from limited case series.

Although highly accurate in the diagnosis of intestinal endometriosis, with an elevated sensitivity and specificity in definition of the compromised intestinal layer, EUS has some limitations. Its use is still restricted to some centers; the equipment and expertise for this test are not yet widely available; the costs are high and, as for other ultrasonographic tests, its reproducibility is low. One of the main drawbacks is the unbearable pain elicited by the examination, which is described by some patients, with a consequent need for sedation or general anesthesia.

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