Objective: To present the principles of laparoscopic treatment for rectal endometriosis and to discuss possible postoperative outcomes.
Material And Methods: Our series included women managed for rectal endometriosis during consecutive 20 months in the Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen--France. Patient's characteristics, symptoms, imaging examination results, surgical treatment and postoperative outcomes were all evaluated retrospectively.
Results: Sixteen patients presenting with rectal endometriosis were managed surgically, (mean age was 35.9 +/- 6.5 years). All women presented at least one severe painful symptom which was typical of a digestive involvement in 12 cases. MRI results suggested a rectal involvement in 14 cases, and endorectal ultrasound examination clearly showed rectal wall infiltration in all patients. The gynaecological stage of surgical treatment was carried out laparoscopically in 13 cases, and the digestive surgical stage in 7 cases. Two limited and 14 segmental rectal resections were performed. Transitory stoma was carried out in 9 women. The length of the surgical procedure depended on the number of endometriosis localizations with a median value of 6 h 30 min. Postoperative complications occurred in 6 women: 2 anastomosis stenosis, 1 anastomosis fistula, 1 abscess of the parietal wall and 1 bladder atonia. Complains of pain were completely or significantly improved in all cases.
Conclusion: Surgical treatment for rectal endometriosis may be carried out laparoscopically. It should be reserved for women presenting with severe painful condition and may contribute to significant improvement. However, the balance of benefit and risks must also be assessed on a case to case basis prior to any decision for or against surgical treatment.
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Zhonghua Fu Chan Ke Za Zhi
January 2025
Pharmaceuticals (Basel)
January 2025
Department of Drug Form Technology, Wroclaw Medical University, Borowska 211 A, 50-556 Wroclaw, Poland.
Introduction: The official implementation of pharmaceutical-grade cannabis raw materials for medicinal use has permitted doctors to prescribe and pharmacists to prepare cannabis-based formulations. The objective of the pharmaceutical development and manufacturing process optimization work was to propose a suppository formulation containing doses of 25 mg and 50 mg of tetra-hydrocannabinol (∆-9-THC) as an alternative to existing inhalable or orally administered formulations. The formulation could be used for rectal or vaginal administration, thereby providing dosage control in the treatment of endometriosis and other conditions involving pain.
View Article and Find Full Text PDFRev Med Chil
July 2024
Departamento de Ciencias Químicas y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O'Higgins, Santiago, Chile.
Unlabelled: Endometriosis is a chronic disease characterized by the growth of the endometrium outside the uterine cavity. In response to estradiol, this tissue begins to proliferate and grow, forming lesions and nodules, which can invade the tissues, causing pelvic pain and infertility. The most widely used pharmacological treatment is progesterone, which manages to reduce symptoms, but approximately one-third of patients develop resistance to treatment.
View Article and Find Full Text PDFJ Minim Invasive Gynecol
January 2025
Department of Radiology, South Lyon University Hospital, Lyon, France.
Biomedicines
November 2024
Department of Reproductive Endocrinology, University Hospital Zurich, Frauenklinikstr. 10, 8091 Zurich, Switzerland.
Background: Endometriosis and adenomyosis are two closely related, estrogen-dependent, benign gynecological diseases. The available evidence on their common pathogenesis and association is limited and often does not address the heterogeneity of both entities. The aim of our study is to investigate the association between different types and localizations of adenomyosis and endometriosis phenotypes, using magnetic resonance imaging (MRI) and laparoscopic findings.
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