By Paola De Nardi, Stefano Ferrrari, Elaine Denny

Deep pelvic endometriosis is likely one of the so much serious expressions of a ailment that can contain the entire pelvic organs – bladder, ureters, rectosigmoid colon – inflicting debilitating signs and resulting in impaired caliber of lifestyles in younger women.
The chapters conceal either diagnostic and healing points of this disorder. The imperative function of diagnostic imaging in surgical choice making is highlighted, in addition to the problems concerned with cautious making plans of surgery, and particular cognizance is paid to minimally invasive techniques.
The paramount significance of a multidisciplinary workforce, concerning the services of radiologists, gastroenterologists, and psychologists, in addition to the talents of the gynecologist, urologist, and colorectal medical professional is underlined during the text.

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Extra info for Deep Pelvic Endometriosis: A Multidisciplinary Approach

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In addition, if the ectopic tissue does not extend beyond the pericystium or ureteral adventitial layer, endoscopy might be useless. Thus, negative endoscopic findings do not necessarily imply the absence of urinary endometriosis. UR biopsy to establish the diagnosis followed by endoscopic ablation remains a useful, minimally invasive option for some patients with localized ureteral endometrioma [61]. 7 Conclusions In conclusion, preoperative instrumental diagnosis of DIE is fundamental to planning the surgical approach.

Hum Reprod 2001;16:2668–2671 Hurd WW. Criteria that indicate endometriosis is the cause of chronic pelvic pain. Obstet Gynecol 1998;92:1029–1032 Porpora MG, Koninckx PR, Piazze J et al. 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.

35. 36. Diagnosis 43 Tariverdian N, Theoharides TC, Siedentopf F et al. Neuroendocrine-immune disequilibrium and endometriosis: an interdisciplinary approach. Semin Immunopathol 2007;29:193–210 Bulun SE. Endometriosis. Review. N Engl J Med 2009;360:268–279 Donnez J, Nisolle M, Squifflet J. Ureteral endometriosis: a complication of rectovaginal endometriotic (adenomyotic) nodules. Fertil Steril 2002;77:32–37 Carmignani L, Vercellini P, Spinelli M et al. Pelvic endometriosis and hydroureteronephrosis.

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