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
Keywords
Related Articles
- EP ID EP380050
- DOI 10.4274/jtgga.2017.0143
- Views 56
- Downloads 0
Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes
Objective: Preterm premature rupture of membranes (PPROM) is closely related with maternal and fetal complications. Therefore, early diagnosis is extremely important to provide maternal and fetal well-being. Many inflamm...
Tumor necrosis factor alfa and interleukin 1 alfa induced phosphorylation and degradation of inhibitory kappa B alpha are regulated by estradiol in endometrial cells
Objective: When bound to the inhibitory kappa B (IкB) protein, the transcription factor nuclear factor kappa B (NF-кB) remains inactively in the cytoplasm. Activated NF-кB upregulates the gene expression of many chemokin...
To clip or not to clip the breast tumor bed? A retrospective look at the geographic miss index and normal tissue index of 110 patients with breast cancer
Objective: Planning of breast radiation for patients with breast conserving surgery often relies on clinical markers such as scars. Lately, surgical clips have been used to identify the tumor location. The purpose of thi...
Overcoming barriers to vaginal hysterectomy: An analysis of perioperative outcomes
Objective: To determine perioperative outcome differences in patients undergoing vaginal hysterectomy based on uterine weight, vaginal delivery, and menopausal state. Material and Methods: Retrospective chart review of 4...
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...