Ultrasound Mapping System of Pelvic Deep Infiltrating Endometriosis: A Useful Instrument for Surgical Treatment and Counseling

Abstract

classified according to AFS (American Fertility Society) criteria. Disease extent, procedures, and complications were recorded. Setting: Private hospital with a multicultural patient profile. Patients: 40 consecutive patients who presented to our clinic with deep infiltrative endometriosis. Intervention: Surgery, preferably laparoscopic, was performed. Measurements and Main Results: Thirty-eight patients underwent laparoscopy. Of these, one operation was converted from laparoscopy to laparotomy. All patients underwent cul-de-sac dissection. Nodule excision was performed in 27 patients. Seven patients had rectosigmoid bowel shaving. Rectosigmoid resection was performed in 7 patients. Four patients had nodules removed from their ureter. Two patients’ nodules were removed from the bladder wall. Complications were rare. One patient had urinary symptoms due to kinking of the ureter. Two patients had subileus, which resolved spontaneously. Conclusion: Deep pelvic endometriosis usually affects multiple sites in pelvis. Bowel is involved in about two/thirds of the patients with advanced disease. Despite its challenging presentation, an experienced team can significantly reduce complication rates.