DEEP ENDOMETRIOSIS: OVERWIEW OF CURRENT RECOMMENDATIONS AND OWN DATA

Abstract

Endometriosis is a chronic inflammatory disease characterized by the presence of endometrial-like tissue outside the uterine cavity. Deep endometriosis is a lesion of the tissue of the abdominal cavity, similar to the endometrium, which spreads on the surface of the peritoneum or under it, is able to penetrate into adjacent structures and is accompanied by fibrosis and a violation of normal anatomy. Treatment of endometriosis includes pain reduction, improvement of fertility due to hormonal suppression of the level of endogenous estrogens, proapoptotic and anti-inflammatory effects on endometrioid tissue, as well as surgical removal or destruction of endometriosis foci and pelvic inflammatory process. But despite numerous studies, the optimal management of patients with deep endometriosis is still the subject of numerous discussions.
 An analysis of modern recommendations for the management of patients with deep endometriosis, the role of medical and surgical treatment in reducing the symptoms of pelvic pain and improving the fertility and quality of life of patients was carried out.
 The standardization of the procedure for surgical treatment of deep endometriosis proposed by us will help reproduce the sequence of surgical steps, which will lead to balancing the completeness of excision of tissues affected by endometriosis, and prevention of intra- and postoperative complications, preservation of female fertility.