Pain and fertility outcomes of nerve-sparing, full-thickness disk or segmental bowel resection for deep infiltrating endometriosis-A prospective cohort study

Introduction: Deep infiltrating endometriosis is a particular form of endometriosis that penetrates the peritoneal surface or it reaches the subserosal neurovascular plexus. Aim: The aim of the authors was to analyze the results of segmental colorectal resections performed for deep infiltrating endometriosis. Method: Between 2009 and 2012, 50 patients underwent segmental rectum or/and sigmoid resection for endometriosis. Results: 21 patients had ultralow rectal resection and 29 patients had low colorectal anastomosis or anterior resection. Concomitant intervention in other organs was required in all cases, including gynecologic procedures (n = 50), additional gynecologic (n = 47), vesical (n = 9) and ureteral (n = 18) resections. The mean number of endometriosis lesions was 2.4±1.8 per patient. In all patients fertility was preserved. Severe surgical complications (Clavien–Dindo stage III or more severe) occurred in 3 patients (6%). Conclusions: The results confirm that segmental bowel resection is an efficient and safe method for the treatment of deep infiltrating colorectal endometriosis. Orv. Hetil., 2014, 155(5), 182–186.

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Spontaneous Healing of a Rectovaginal Fistula Developing after Laparoscopic Segmental Bowel Resection for Intestinal Deep Infiltrating Endometriosis

Case Reports in Obstetrics and Gynecology ◽

10.1155/2013/837903 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

William Kondo ◽

Reitan Ribeiro ◽

Carlos Henrique Trippia ◽

Monica Tessmann Zomer

Keyword(s):

Rectovaginal Fistula ◽

Bowel Resection ◽

Intestinal Anastomosis ◽

Pelvic Abscess ◽

Deep Infiltrating Endometriosis ◽

Laparoscopic Treatment ◽

Spontaneous Healing ◽

Uterosacral Ligaments ◽

Segmental Bowel Resection ◽

Infiltrating Endometriosis

The surgical treatment of intestinal deep infiltrating endometriosis has an associated risk of major complications such as dehiscence of the intestinal anastomosis, pelvic abscess, and rectovaginal fistula. The management of postoperative rectovaginal fistula frequently requires a reoperation and the construction of a stoma for temporary fecal diversion. In this paper we describe a 27-year-old woman undergoing laparoscopic treatment of deep infiltrating endometriosis (extramucosal cystectomy, resection of the uterosacral ligaments, resection of the posterior vaginal fornix, and segmental bowel resection) complicated by a rectovaginal fistula, which healed spontaneously with nonsurgical conservative treatment.

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Success Factors of Laparoscopic Nerve-sparing Radical Hysterectomy for Preserving Bladder Function in Patients with Cervical Cancer: A Protocol-Based Prospective Cohort Study

Annals of Surgical Oncology ◽

10.1245/s10434-014-4197-1 ◽

2014 ◽

Vol 22 (6) ◽

pp. 1987-1995 ◽

Cited By ~ 16

Author(s):

Hee Seung Kim ◽

Tae Hun Kim ◽

Dong Hoon Suh ◽

Sang Youn Kim ◽

Min A. Kim ◽

...

Keyword(s):

Cervical Cancer ◽

Cohort Study ◽

Prospective Cohort Study ◽

Radical Hysterectomy ◽

Prospective Cohort ◽

Success Factors ◽

Bladder Function ◽

Nerve Sparing

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Hysteroscopic vaginoscopy. An additional diagnostic tool for recto-vaginal deep infiltrating endometriosis

Journal of Endometriosis and Pelvic Pain Disorders ◽

10.1177/2284026520967865 ◽

2020 ◽

pp. 228402652096786

Author(s):

Brunella Zizolfi ◽

Virginia Foreste ◽

Attilio Di Spiezio Sardo ◽

Pierluigi Giampaolino ◽

Annarita Gencarelli ◽

...

Keyword(s):

Bowel Resection ◽

Uterine Cavity ◽

Accurate Diagnosis ◽

Endometrial Tissue ◽

Deep Infiltrating Endometriosis ◽

Resonance Imaging ◽

Total Hysterectomy ◽

Segmental Bowel Resection ◽

History Of ◽

Infiltrating Endometriosis

Endometriosis is the presence of endometrial tissue outside the uterine cavity. Rectovaginal infiltration is present in 5% to 25% of the patients diagnosed with endometriosis. Accurate diagnosis is imperative for adequate counseling. Hysteroscopic vaginoscopy allows the inspection of the posterior vaginal fornix, not only providing better visualization of the area due to image magnification, but also allowing to obtain biopsy providing pathologic confirmation. We report the case of a 49-year-old nulliparous patient with long history of severe dysmenorrhea, deep dyspareunia and debilitating chronic pelvic pain not responding to medical treatment. On physical exam, recto-vaginal tender nodularity was palpated. Vaginal ultrasound and magnetic resonance imaging confirmed the presence of the nodular formation extending up to the rectum. In-office vaginoscopy revealed a perforated bulge on the uterine cervix, mimicking a double cervix. A biopsy of the nodule confirmed the presence of endometrial tissue, confirming the diagnosis of endometriosis. Patient underwent total hysterectomy with excision of deep infiltrating endometriosis which required segmental bowel resection with diverting loop colostomy. The final pathology confirmed the diagnosis of deep infiltrating endometriosis.

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