Endometriosis surgery: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 5: | Line 5: | ||
==Overview== | ==Overview== | ||
Patients with failed medical therapy and patients with stage 3 or stage 4 disease are candidates for surgical therapy. | Patients with failed medical therapy and patients with stage 3 or stage 4 disease are candidates for surgical therapy. [[Laser]] and excision of the lesions is done for isolated lesions, total [[hysterectomy]] is reserved for patients with extensive disease. | ||
==Surgery== | ==Surgery== | ||
Surgical therapy for endometriosis can be conservative or definitive based on the patient's presentation.<ref name="pmid28189295">{{cite journal| author=Singh SS, Suen MW| title=Surgery for endometriosis: beyond medical therapies. | journal=Fertil Steril | year= 2017 | volume= 107 | issue= 3 | pages= 549-554 | pmid=28189295 | doi=10.1016/j.fertnstert.2017.01.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28189295 }} </ref> | Surgical therapy for endometriosis can be conservative or definitive based on the patient's presentation.<ref name="pmid28189295">{{cite journal| author=Singh SS, Suen MW| title=Surgery for endometriosis: beyond medical therapies. | journal=Fertil Steril | year= 2017 | volume= 107 | issue= 3 | pages= 549-554 | pmid=28189295 | doi=10.1016/j.fertnstert.2017.01.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28189295 }} </ref> | ||
*'''Conservative therapy:''' | *'''Conservative therapy:''' | ||
**It is preferred in young women who desire to get pregnant and in patients with no improvement of pain with medical therapy. | **It is preferred in young women who desire to get [[pregnant]] and in patients with no improvement of pain with medical therapy. | ||
**Sugery includes removal of the endometrial lesions with excision of destruction of the lesion by laser or electrocautery. | **Sugery includes removal of the endometrial lesions with excision of destruction of the lesion by [[laser]] or [[electrocautery]]. | ||
**Laparoscopic uterosacral nerve ablation or laparoscopic presacral neurectomy can be done for chronic pelvic pain.<ref name="pmid26441217">{{cite journal| author=Api M| title=Surgery for endometriosis-related pain. | journal=Womens Health (Lond) | year= 2015 | volume= 11 | issue= 5 | pages= 665-9 | pmid=26441217 | doi=10.2217/whe.15.52 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26441217 }} </ref> | **Laparoscopic uterosacral nerve ablation or laparoscopic presacral neurectomy can be done for chronic pelvic pain.<ref name="pmid26441217">{{cite journal| author=Api M| title=Surgery for endometriosis-related pain. | journal=Womens Health (Lond) | year= 2015 | volume= 11 | issue= 5 | pages= 665-9 | pmid=26441217 | doi=10.2217/whe.15.52 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26441217 }} </ref> | ||
*'''Definitive surgery:''' | *'''Definitive surgery:''' | ||
**It is preferred in patients after child bearing age and elderly women or women with ureteral or bowel obstruction.<ref name="pmid28186620">{{cite journal| author=Cranney R, Condous G, Reid S| title=An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma. | journal=Acta Obstet Gynecol Scand | year= 2017 | volume= 96 | issue= 6 | pages= 633-643 | pmid=28186620 | doi=10.1111/aogs.13114 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28186620 }} </ref> | **It is preferred in patients after child bearing age and elderly women or women with ureteral or [[bowel obstruction]].<ref name="pmid28186620">{{cite journal| author=Cranney R, Condous G, Reid S| title=An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma. | journal=Acta Obstet Gynecol Scand | year= 2017 | volume= 96 | issue= 6 | pages= 633-643 | pmid=28186620 | doi=10.1111/aogs.13114 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28186620 }} </ref> | ||
**Definitive surgery is | **Definitive surgery preferred is a total [[hysterectomy]] with [[Salpingo-oophorectomy|bilateral salpingo-oophorectomy]]. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 15:30, 20 June 2017
|
Endometriosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Endometriosis surgery On the Web |
|
American Roentgen Ray Society Images of Endometriosis surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
Patients with failed medical therapy and patients with stage 3 or stage 4 disease are candidates for surgical therapy. Laser and excision of the lesions is done for isolated lesions, total hysterectomy is reserved for patients with extensive disease.
Surgery
Surgical therapy for endometriosis can be conservative or definitive based on the patient's presentation.[1]
- Conservative therapy:
- It is preferred in young women who desire to get pregnant and in patients with no improvement of pain with medical therapy.
- Sugery includes removal of the endometrial lesions with excision of destruction of the lesion by laser or electrocautery.
- Laparoscopic uterosacral nerve ablation or laparoscopic presacral neurectomy can be done for chronic pelvic pain.[2]
- Definitive surgery:
- It is preferred in patients after child bearing age and elderly women or women with ureteral or bowel obstruction.[3]
- Definitive surgery preferred is a total hysterectomy with bilateral salpingo-oophorectomy.
References
- ↑ Singh SS, Suen MW (2017). "Surgery for endometriosis: beyond medical therapies". Fertil Steril. 107 (3): 549–554. doi:10.1016/j.fertnstert.2017.01.001. PMID 28189295.
- ↑ Api M (2015). "Surgery for endometriosis-related pain". Womens Health (Lond). 11 (5): 665–9. doi:10.2217/whe.15.52. PMID 26441217.
- ↑ Cranney R, Condous G, Reid S (2017). "An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma". Acta Obstet Gynecol Scand. 96 (6): 633–643. doi:10.1111/aogs.13114. PMID 28186620.