Endometriosis: What a Colorectal Surgeon Should Know

ABSTRACT

Endometriosis is a common gynecologic disorder that has a mechanical and immunologic etiology. The majority of cases involve the pelvis and the diagnosis is usually made surgically. Symptoms include dysmenorrhea, pelvic pain, and dyspareunia. Therapy can be medical, surgical, or a combination of the two. The colon and rectal surgeon will usually encounter endometriosis as an accidental finding. Excision with minimal trauma to adjacent tissues is preferred.

KEYWORDS

Endometriosis - infertility - dyspareunia

REFERENCES

• 1 Sampson J A. Peritoneal endometriosis due to menstrual dissemination of endometrial tissue into the peritoneal cavity.  Am J Obstet Gynecol . 1927;  14 422-429
• 2 Halme J, Hammond M, Hulka J, Raj S, Talbert L. Retrograde menstruation in healthy women and in patients with endometriosis.  Obstet Gynecol . 1984;  64 151-154
• 3 Osterlynck D J, Cornillie F J, Waer M, Vandeputte M, Konickx P R. Women with endometriosis show a defect in natural killer activity resulting in a decreased cytotoxicity to autologous endometrium.  Fertil Steril . 1991;  56 45-51
• 4 Khorram O, Taylor R N, Ryan I P, Schall T J, Landers D V. Peritoneal fluid concentrations of the cytokine RANTES correlate with the severity of endometriosis.  Am J Obstet Gynecol . 1993;  169 1545-1549
• 5 Nisolle M, Casanas-Roux F, Anaf V, Mine J-M, Donnez J. Morphometric study of the stromal vascularization in peritoneal endometriosis.  Fertil Steril . 1993;  59 681-684
• 6 Jansen R, Russel P. Nonpigmented endometriosis: clinical, laparoscopic, and pathologic definition.  Am J Obstet Gynecol . 1986;  155 1154-1159
• 7 Martin D C, Hubert G D, Vander Zwaag R. et al . Laparoscopic appearances of peritoneal endometriosis.  Fertil Steril . 1989;  51 63-67
• 8 Cornillie F J, Oosterlynck D, Lauweryns J M. et al . Deeply infiltrating pelvic endometriosis: histology and clinical significance.  Fertil Steril . 1990;  53 978-983
• 9 Redwine D B. Laparoscopic en bloc resection for treatment of the obliterated cul-de-sac in endometriosis.  J Reprod Med . 1992;  37 695-698
• 10 Koninckx P R, 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
• 11 Koninckx P R, Meuleman C, Oosterlynck D. et al . Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration.  Fertil Steril . 1996;  65 280-287
• 12 Koninckx P R, Riittenen L, Seppala M. et al . CA-125 and placental protein 14 concentrations in plasma and peritoneal fluid of women with deeply infiltrating pelvic endometriosis.  Fertil Steril . 1992;  57 523-530
• 13 The American Fertility Society. Classification of endometriosis.  Fertil Steril . 1979;  32 633-634
• 14 American Fertility Society. Revised American Fertility Society classification of endometriosis.  Fertil Steril . 1985;  43 351-352
• 15 Hornstein M D, Hemmings R, Yuzpe A A. et al . Use of nafarelin versus placebo after reductive laparoscopic surgery for endometriosis.  Fertil Steril . 1997;  68 860-864
• 16 Kistner R W. Treatment of endometriosis by inducing pseudo-pregnancy with ovarian hormones.  Fertil Steril . 1959;  10 539-554
• 17 Buttram Jr C V, Belue J B, Reiter R. Interim report of a study of danazol for the treatment of endometriosis.  Fertil Steril . 1982;  37 478