Abstract

ARANGO MARTINEZ, ADRIANA. Deep endometriosis: a review. CES Med. [online]. 2009, vol.23, n.1, pp.47-60. ISSN 0120-8705.

This paper is a review of infiltrating or deep endometriosis and includes the definition, clinic, diagnostic tools and different options of medical and surgical treatment. Deep endometriosis is defined as the presence of endometrial injuries that infiltrate the tissue in more than 5mm, are located in the retro-peritoneum in different places than the common endometriosis which jeopardize different structures and organs such as: intestine, ureter, bladder, uterosacral ligaments and the rectovaginal area, being able to alter the woman's quality of life. The most frequent symptoms include dysmenorrhoea, dyspareunia and dysquexia. An approach to the diagnosis includes a good clinical history with emphasis in the painful symptoms, physical examination with pelvis evaluation and the diagnostic tools that depend on the jeopardized system and includes transvaginal ultrasound, transrectal ultrasound and/or magnetic resonance, colon by enema with double contrast and the excretory urography or urotac. Surgery is the most effective option for the treatment at this time, depending on the location and the involvement of the different organs; nevertheless, pharmacological treatment with precise indications is a valid conduct and could be the main or a complementary option, in spite of the recurrences of symptoms or injuries. Since the infiltrating or deep endometriosis is a multi-systemic disease, it must be handled by a multidisciplinary team.

Keywords : Endometriosis; Deep; Classification; Treatment.

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