Segmental Rectum Resection for Deep Endometriosis and Excision Similarly Improve Sexual Function and Pain

Asencio, Fernanda de Almeida; Fins, Raphael Jose Palhares; Mitie, Carolina Kami; Ussia, Anastasia; Wattiez, Arnauld; Ribeiro, Helizabet Salomao; Ribeiro, Paulo Ayrosa; Koninckx, Philippe Robert

doi:10.3390/clinpract13040071

Cited by 2 publications

(1 citation statement)

References 88 publications

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“…Only ten major problems in managing endometriosis were described, as perceived by the authors, who are deep endometriosis surgeons. Minor issues resulting from less expertise or the need for a more holistic approach, including sexual well-being [ 63 , 64 ], were not discussed. We also avoided items that can be addressed in RCTs or the integration and extrapolation of trial-based recommendations and classification systems.…”

Section: Discussionmentioning

confidence: 99%

The 10 “Cardinal Sins” in the Clinical Diagnosis and Treatment of Endometriosis: A Bayesian Approach

Koninckx

Ussia²,

Gordts³

et al. 2023

JCM

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Evidence-based data for endometriosis management are limited. Experiments are excluded without adequate animal models. Data are limited to symptomatic women and occasional observations. Hormonal medical therapy cannot be blinded if recognised by the patient. Randomised controlled trials are not realistic for surgery, since endometriosis is a variable disease with low numbers. Each diagnosis and treatment is an experiment with an outcome, and experience is the means by which Bayesian updating, according to the past, takes place. If the experiences of many are similar, this holds more value than an opinion. The combined experience of a group of endometriosis surgeons was used to discuss problems in managing endometriosis. Considering endometriosis as several genetically/epigenetically different diseases is important for medical therapy. Imaging cannot exclude endometriosis, and diagnostic accuracy is limited for superficial lesions, deep lesions, and cystic corpora lutea. Surgery should not be avoided for emotional reasons. Shifting infertility treatment to IVF without considering fertility surgery is questionable. The concept of complete excision should be reconsidered. Surgeons should introduce quality control, and teaching should move to explain why this occurs. The perception of information has a personal bias. These are the major problems involved in managing endometriosis, as identified by the combined experience of the authors, who are endometriosis surgeons.

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Section: Discussionmentioning

confidence: 99%

The 10 “Cardinal Sins” in the Clinical Diagnosis and Treatment of Endometriosis: A Bayesian Approach

Koninckx

Ussia²,

Gordts³

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

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Surgical treatment of colorectal endometriosis: an updated review

Schneyer,

Hamilton,

Meyer

et al. 2024

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review This review aims to summarize recent literature on the surgical treatment of colorectal endometriosis. Recent findings The last decade has seen a surge in the number of studies on bowel endometriosis, with a focus on preoperative evaluation, perioperative management, surgical approach, and surgical outcomes. Many of these studies have originated from large-volume referral centers with varying surgical approaches and philosophies. Colorectal surgery for endometriosis seems to have a positive impact on patient symptoms, quality of life, and fertility. However, these benefits must be weighed against a significant risk of postoperative complications and the potential for long-term bowel or bladder dysfunction, especially for more radical procedures involving the lower rectum. Importantly, most studies regarding surgical technique and outcomes have been limited by their observational design. Summary The surgical management of bowel endometriosis is complex and should be approached by a multidisciplinary team. Methodical preoperative evaluation, including appropriate imaging, is vital for surgical planning and patient counseling. The decision to perform a more conservative or radical excision is nuanced and remains an area of controversy. High quality studies in the form of multicenter randomized controlled trials are needed before clear recommendations can be made.

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Segmental Rectum Resection for Deep Endometriosis and Excision Similarly Improve Sexual Function and Pain

Cited by 2 publications

References 88 publications

The 10 “Cardinal Sins” in the Clinical Diagnosis and Treatment of Endometriosis: A Bayesian Approach

The 10 “Cardinal Sins” in the Clinical Diagnosis and Treatment of Endometriosis: A Bayesian Approach

Surgical treatment of colorectal endometriosis: an updated review

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