The surgical treatment of deep infiltrating endometriosis is challenging and complex. Currently, the gold standard for patient care is the referral to tertiary centers with a multidisciplinary team including gynecologists, colorectal surgeon and urologist with adequate training in advanced laparoscopic surgery. The surgical technique is essential to adequately manage the disease and to minimize...

To cite: Ribeiro C, Nogueira F, Guerreiro SC, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2015209464 DESCRIPTION Endometriosis, the presence of functional endometrial tissue outside the uterus, occurs in about 3–10% of women of reproductive age and is a cause of chronic pelvic pain and infertility for some. Bowel involvement may be present in about 5–10...

OBJECTIVE To compare the efficacy and safety of complete and incomplete excision of deep infiltrating endometriosis (DIE). METHODS Ninety-three women who underwent complete excision (n=55) or incomplete surgery of DIE (n=38) between January 2011 and December 2013 were included in this retrospective cohort study. Surgical data, and follow-up information of the patients were analyzed. RESULTS...

Over the last several years, with improvements in laparoscopic surgical techniques, specialized surgical teams have successfully been able to safely excise deep endometriosis lesions that infiltrate into andmay compromise the bladder, bowel, ureter and other pelvic regions. Excision of deep infiltrating endometriosis (DIE) lesions warrant special surgical approaches and may necessitate either a...

BACKGROUND The aim of this study was to evaluate the leptin levels in the serum and peritoneal fluid (PF) and the protein expression in three different peritoneal ectopic implants in patients who underwent surgery for deep infiltrating endometriosis. METHODS All patients had been treated at the Department of Gynecology of the Pedro Ernesto University Hospital, Rio de Janeiro. The study group ...

Endometriosis, which is defined as the presence of ectopic endometrial glands and stroma outside the uterus, is a common cause of pelvic pain and infertility, affecting as many as 10% of premenopausal women. Because its effects may be devastating, radiologists should be familiar with the various imaging manifestations of the disease, especially those that allow its differentiation from other pe...

STUDY QUESTION Is there a difference in functional outcome between conservative versus radical rectal surgery in patients with large deep endometriosis infiltrating the rectum 2 years postoperatively? SUMMARY ANSWER No evidence was found that functional outcomes differed when conservative surgery was compared to radical rectal surgery for deeply invasive endometriosis involving the bowel. W...

BACKGROUND Successful surgical treatment of deep bowel endometriosis depends on obtaining detailed information about the lesions, prior to the procedure. The objective of this study was to determine the capability of transvaginal ultrasonography with bowel preparation (TVUS-BP) to predict the presence of one or more rectosigmoid nodules and the deepest bowel layer affected by the disease. MET...

The patient was a 49-year-old Japanese female with a history of surgery for ovarian endometriosis and adenomyosis. A retroperitoneal mass was also identified preo peratively. A later computed tomography (CT) examination revealed that the mass had grown. On unenhanced CT, the mass with a diameter of 4.5 cm was located to the right of the rectum and in front of the sacrum. It consisted of soft ti...

BACKGROUND In this study, we characterized the fibromuscular (FM) tissue, typical of deeply infiltrating endometriosis, investigated which cells are responsible for the FM reaction and evaluated whether transforming growth factor-beta (TGF-beta) signaling is involved in this process. METHODS FM differentiation and TGF-beta signaling were assessed in deeply infiltrating endometriosis lesions (...