Endometriosis surgical

BergerG. 1994. Epidemiology of endometriosis. In Modem surgical management of endometriosis. 

The most common benign gynecological diseases, for prevalence and related economic costs, are probably uterine leiomyomas and endometriosis (Stewart 2001 Missmer et al. 2003). Notwithstanding the fact that both conditions are characterized by a sex-hormone-related development and by the possibility of a medical treatment consisting of hormonal manipulation, at present the main approach to these conditions is surgical excision (Palomba et al. 2006a Olive etal. 2001). 

The herbs in this group can be selected as chief and deputies to dissolve congealed blood they can also stimulate blood circulation. They are mainly used to treat the more severe or chronic syndromes of blood stagnation where the blood becomes thicker and blood clots are formed, such as in atherosclerosis, hyperlipemia, thrombosis, endometriosis, adhesions in chronic infection and after surgical operations. 

Endometriosis Endometriosis, which was formerly treated by surgical removal of the ovaries and uterus, is now treated with the continuous administration of progestin, or with progestin combined with estrogen. In addition, progestin may be useful in the management of endometrial carcinoma. 

Endometriosis has been observed in monkeys chronically exposed to 2,3,7,8-TCDD in the diet (Rier et al. 1993). A possible association between 2,3,7,8-TCDD and endometriosis is supported by rat and mouse studies using surgically induced models of endometriosis (Cummings et al. 1996 Johnson et al. 1997). 

In contrast, Foster et al. (1997) found that 2,3,7,8-TCDD exposure diminished endometrial tissue growth in mice. These studies used different models of surgically induced endometriosis and highlight the... 

Options are medical hormonal treatments and/or surgery. Surgical treatment by laparoscopic ablation of endometriotic lesions plus adhesiolysis may improve fertility. Hormonal treatments should not be used for endometriosis in women with fertility problems as they tend to lead to ovarian suppression. Laparoscopic ablation of endometrial deposits may relieve pain in some women. Radical surgery (e.g. total abdominal hysterectomy, salpingo-oophorectomy or both) is reserved for women who have completed their family and in whom other treatments have failed. It is usually curative although... 

There are no physical examination findings or laboratory tests that are considered diagnostic for endometriosis. A definitive diagnosis can be made only via surgical visualization of lesions. Confirmation of diagnosis is not necessary in all cases. 

Endometriosis-related pain may be treated by medical or surgical therapy. Empirical medical therapy is likely more cost-effective and is recommended based on consensus guidelines. 

Recurrence rates of endometriosis-related pain are high after both medical and surgical therapies. Extended use of medical therapy or postoperative use of medical therapy may be needed to maintain efficacy. 

Endometriosis-related infertility is unresponsive to medical therapy. Conservative surgical therapy is the preferred treatment. 

Endometriosis should be suspected in women with subfertility, dysmenorrhea, dyspareunia, or chronic pelvic pain. A definitive diagnosis can be made only by direct surgical visualization of endometrial lesions. Lesions typically are found in the pelvis... 

The treatment for an asymptomatic patient with endometriosis consists of expectant management (watchful waiting) only because therapy is not indicated unless symptoms develop. For symptomatic patients, the foundation of therapy includes medical treatment, surgical treatment, or both. To date, no studies have compared medical and surgical treatment directly as first-line therapy. Furthermore,... 

Surgical intervention in endometriosis may be used as both a diagnostic and a therapeutic tool. Goals of conservative surgical therapy include destruction of endometrial implants, removal of lesions, and restoration of normal pelvic structure to treat associated pain and infertihty. Although considered the only definitive therapy for endometriosis, radical surgery to remove the uterus and ovaries should be considered only in women not desiring future fertility. 

Several cost considerations must be made when choosing endometriosis therapy. Costs of medical therapy must be weighed against the cost of surgical therapy, and the costs of each type of medical therapy must be weighed against another. 

Endometriosis-related pain should be relieved within 2 months of initiating medical therapy. If symptoms persist, consideration should be given to different medical and/or surgical therapy. For endometriosis-related infertility, most experts recommend 6 months of watchful waiting after surgical intervention. If pregnancy is not achieved within that time, assisted reproductive techniques can be considered. 

Adamson GD, Pasta DJ. Surgical treatment of endometriosis-associated infertility Meta-analysis compared with survival analysis. Am J Obstet Gynecol 1994 171 1488-1504. 

Martin DC, O Conner DT. Surgical management of endometriosis-associated pain. Obstet Gynecol Clin North Am 2003 30 151-162. 

Winkel CA, Scialli AR. Medical and surgical therapies for pain associated with endometriosis. J Womens Health Gend Based Med 2001 10 137-162. 

Clindamycin, an aminoglycoside, is indicated in serious respiratory tract infections such as emphysema, anaerobic pneumonitis, and lung abscess serious skin and soft-tissue infections septicemia intra-abdominal infections such as peritonitis and intra-abdominal abscess infections of the female pelvis and genital tract such as endometriosis, nongonococcal tubo-ovarian abscess, pelvic celluhtis, and post-surgical vaginal cuff infection. 

---