International Journal of Women's Health (Jan 2020)
Bowel Endometriosis: Current Perspectives on Diagnosis and Treatment
Abstract
Nassir Habib,1 Gabriele Centini,2 Lucia Lazzeri,2 Nicola Amoruso,2 Lionel El Khoury,3 Errico Zupi,2 Karolina Afors4 1Department of Obstetrics and Gynaecology, Beaujon Hospital-University of Paris, Clichy Cedex 92110, France; 2Department of Molecular and Developmental Medicine, University of Siena, Ospedale Santa Maria alle Scotte, Siena 53100, Italy; 3Department of Colorectal Surgery-Delafontaine Hospital, Saint Denis 93200, France; 4Department of Obstetrics and Gynaecology, Whittington Hospital, London, UKCorrespondence: Karolina Afors Email [email protected]: Endometriosis is a chronic condition primarily affecting young women of reproductive age. Although some women with bowel endometriosis may be asymptomatic patients typically report a myriad of symptoms such as alteration in bowel habits (constipation/diarrhoea) dyschezia, dysmenorrhoea and dyspareunia in addition to infertility. To date, there are no clear guidelines on the evaluation of patients with suspected bowel endometriosis. Several techniques have been proposed including transvaginal and/or transrectal ultrasonography, magnetic resonance imaging, and double-contrast barium enema. These different imaging modalities provide greater information regarding presence, location and extent of endometriosis ensuring patients are adequately informed whilst also optimizing preoperative planning. In cases where surgical management is indicated, surgery should be performed by experienced surgeons, in centres with access to multidisciplinary care. Treatment should be tailored according to patient symptoms and wishes with a view to excising as much disease as possible, whilst at the same time preserving organ function. In this review article current perspectives on diagnosis and management of bowel endometriosis are discussed.Keywords: endometriosis, bowel endometriosis, segmental resection, recurrence, infertility
