Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3122
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
The typical presentation of endometriosis is pelvic pain. Patients with with endometriosis often have associated fertility disorders even if their relationship with the symptoms and signs of endometriosis is not evident. The first line of treatment for endometriosis must be surgery. In case of infertility the preferred approach is laparoscopic, maybe in association with medical treatment and possibly followed up by a second-look. In cases with relevant pelvic pain and involvement of other organs, laparotomy is necessary, particularly when a deep endometriosis is infiltrating the uterosacral ligaments, the rectovaginal septum and the bladder. Medical treatment of endometriosis is based upon the hormone-dependency of the endometriotic lesions inducing a resting status. Adhesions, endometriomas or fibrous sequelae do not respond to medical treatment. We describe a case of recurrent endometriosis treated with radical surgery for relevant lesions and fibrous adhesions of ureters with consequent bilateral hydronephrosis.
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