Endometriozise Bağlı Ağrı; Cerrahi Tedavi
Özet
Endometriozis, ektopik endometrial dokuların var olduğu kronik enflamatuar bir hastalıktır. Bu hastalık asemptomatik olabileceği gibi endometrial dokunun yerine göre hastaların kliniği de değişebilir. Tedavi önerileri genellikle semptomlara, hastanın yaşına ve fertilite durumuna göre belirlenir.
Endometriozisin cerrahi olarak çıkarılması fertilite sonuçlarını ve ağrı semptomlarını iyileştirebilir, ancak cerrahinin ne zaman gerekli olduğuna dair sınırlı veri bulunmaktadır. Endometrioma cerrahisinde over rezervi etkilenebileceğinden kritik faktörler göz önünde bulundurulmalıdır.
Bu bölüm, farklı endometriozis tiplerinin yönetiminde en iyi cerrahi tedavi yaklaşımı konusunda değişen büyük topluluk kılavuzlarını sunmayı amaçlamaktadır.
Endometriosis is a chronic inflammatory disease in which ectopic endometrial tissues are present. This disease may be asymptomatic or the clinical presentation may vary depending on the location of the endometrial tissue. Treatment recommendations are usually based on symptoms, patient age and fertility status.
Surgical removal of endometriosis may improve fertility outcomes and pain symptoms, but there is limited data on when surgery is necessary. Critical factors should be considered in endometrioma surgery as ovarian reserve may be affected.
This section aims to present the varying large community guidelines on the best surgical treatment approach in the management of different types of endometriosis.
Referanslar
Https://Www.Uptodate.Com/Contents/Endometriosis-Surgical-Management-Of-Pelvic-Pain/Print?Source=History_Widget Yazar: Dan I Lebovic, Md Bölüm Edıtörü: Tommaso Falcone, Md, Frcsc, Facog Edıtör Yardımcısı: Kristen Eckler, Tıp Doktoru, Facog. Literatür Taraması Günceldir: Tem 2024. Bu Konu Son Güncellenme Tarihi: 20 Mar 2024 .
Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril 2014; 101:927.
Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open 2022; 2022:hoac009.
Shakiba K, Bena JF, McGill KM, ve diğerleri. Endometriozisin cerrahi tedavisi: daha fazla cerrahiye ihtiyaç duyulması üzerine 7 yıllık takip. Obstet Gynecol 2008; 111:1285.
Weir E, Mustard C, Cohen M, Kung R. Endometriosis: what is the risk of hospital admission, readmission, and major surgical intervention? J Minim Invasive Gynecol 2005; 12:486.
Maresh MJ, Metcalfe MA, McPherson K, et al. The VALUE national hysterectomy study: description of the patients and their surgery. BJOG 2002; 109:302.
Spilsbury K, Hammond I, Bulsara M, Semmens JB. Morbidity outcomes of 78,577 hysterectomies for benign reasons over 23 years. BJOG 2008; 115:1473.
MacDonald SR, Klock SC, Milad MP. Long-term outcome of nonconservative surgery (hysterectomy) for endometriosis-associated pain in women <30 years old. Am J Obstet Gynecol 1999; 180:1360.
Farquhar CM, Sadler L, Harvey SA, Stewart AW. The association of hysterectomy and menopause: a prospective cohort study. BJOG 2005; 112:956.
Moorman PG, Myers ER, Schildkraut JM, et al. Effect of hysterectomy with ovarian preservation on ovarian function. Obstet Gynecol 2011; 118:1271.
Halmesmäki K, Hurskainen R, Tiitinen A, et al. A randomized controlled trial of hysterectomy or levonorgestrel-releasing intrauterine system in the treatment of menorrhagia-effect on FSH levels and menopausal symptoms. Hum Reprod 2004; 19:378.
Kaiser R, Kusche M, Würz H. Hormone levels in women after hysterectomy. Arch Gynecol Obstet 1989; 244:169.
Oldenhave A, Jaszmann LJ, Everaerd WT, Haspels AA. Hysterectomized women with ovarian conservation report more severe climacteric complaints than do normal climacteric women of similar age. Am J Obstet Gynecol 1993; 168:765.
Siddle N, Sarrel P, Whitehead M. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril 1987; 47:94.
Riedel HH, Lehmann-Willenbrock E, Semm K. Ovarian failure phenomena after hysterectomy. J Reprod Med 1986; 31:597.
Namnoum AB, Hickman TN, Goodman SB, et al. Incidence of symptom recurrence after hysterectomy for endometriosis. Fertil Steril 1995; 64:898.
Farquhar CM, Harvey SA, Yu Y, et al. A prospective study of 3 years of outcomes after hysterectomy with and without oophorectomy. Am J Obstet Gynecol 2006; 194:711.
Parker WH, Broder MS, Chang E, et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses' health study. Obstet Gynecol 2009; 113:1027.
Jacoby VL, Grady D, Wactawski-Wende J, et al. Oophorectomy vs ovarian conservation with hysterectomy: cardiovascular disease, hip fracture, and cancer in the Women's Health Initiative Observational Study. Arch Intern Med 2011; 171:760.
Løkkegaard E, Jovanovic Z, Heitmann BL, et al. The association between early menopause and risk of ischaemic heart disease: influence of Hormone Therapy. Maturitas 2006; 53:226.
Rivera CM, Grossardt BR, Rhodes DJ, et al. Increased cardiovascular mortality after early bilateral oophorectomy. Menopause 2009; 16:15.
Shuster LT, Rhodes DJ, Gostout BS, et al. Premature menopause or early menopause: long-term health consequences. Maturitas 2010; 65:161.
Chapron C, Fauconnier A, Goffinet F, et al. Laparoscopic surgery is not inherently dangerous for patients presenting with benign gynaecologic pathology. Results of a meta-analysis. Hum Reprod 2002; 17:1334.
Crosignani PG, Vercellini P, Biffignandi F, et al. Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril 1996; 66:706.
Soto E, Luu TH, Liu X, et al. Laparoscopy vs. Robotic Surgery for Endometriosis (LAROSE): a multicenter, randomized, controlled trial. Fertil Steril 2017; 107:996.
Meuleman C, Tomassetti C, D'Hoore A, et al. Surgical treatment of deeply infiltrating endometriosis with colorectal involvement. Hum Reprod Update 2011; 17:311.
Young SW, Dahiya N, Yi J, et al. Impact of Uterine Sliding Sign in Routine United States Ultrasound Practice. J Ultrasound Med 2021; 40:1091.
Piessens S, Edwards A. Sonographic Evaluation for Endometriosis in Routine Pelvic Ultrasound. J Minim Invasive Gynecol 2020; 27:265.
Guerriero S, Condous G, van den Bosch T, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol 2016; 48:318.
Practice bulletin no. 114: management of endometriosis. Obstet Gynecol 2010; 116:223.
Yap C, Furness S, Farquhar C. Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev 2004; :CD003678.
ACOG Practice Bulletin No. 195: Prevention of Infection After Gynecologic Procedures. Obstet Gynecol 2018; 131:e172. Reaffirmed 2022.
Güenaga KF, Matos D, Wille-Jørgensen P. Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev 2011; :CD001544.
Demco L. Mapping the source and character of pain due to endometriosis by patient-assisted laparoscopy. J Am Assoc Gynecol Laparosc 1998; 5:241.
Parker JD, Sinaii N, Segars JH, et al. Adhesion formation after laparoscopic excision of endometriosis and lysis of adhesions. Fertil Steril 2005; 84:1457.
diZerega GS, Coad J, Donnez J. Clinical evaluation of endometriosis and differential response to surgical therapy with and without application of Oxiplex/AP* adhesion barrier gel. Fertil Steril 2007; 87:485.
Johnson NP, Hummelshoj L, World Endometriosis Society Montpellier Consortium. Consensus on current management of endometriosis. Hum Reprod 2013; 28:1552.
Zullo F, Palomba S, Zupi E, et al. Effectiveness of presacral neurectomy in women with severe dysmenorrhea caused by endometriosis who were treated with laparoscopic conservative surgery: a 1-year prospective randomized double-blind controlled trial. Am J Obstet Gynecol 2003; 189:5.
Zullo F, Palomba S, Zupi E, et al. Long-term effectiveness of presacral neurectomy for the treatment of severe dysmenorrhea due to endometriosis. J Am Assoc Gynecol Laparosc 2004; 11:23.
Johnson NP, Farquhar CM, Crossley S, et al. A double-blind randomised controlled trial of laparoscopic uterine nerve ablation for women with chronic pelvic pain. BJOG 2004; 111:950.
Daniels J, Gray R, Hills RK, et al. Laparoscopic uterosacral nerve ablation for alleviating chronic pelvic pain: a randomized controlled trial. JAMA 2009; 302:955.
Proctor ML, Latthe PM, Farquhar CM, et al. Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev 2005; :CD001896.
Duffy JM, Arambage K, Correa FJ, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2014; :CD011031.
Wheeler JM, Malinak LR. Recurrent endometriosis: incidence, management, and prognosis. Am J Obstet Gynecol 1983; 146:247.
Long AJ, Kaur P, Lukey A, et al. Reoperation and pain-related outcomes after hysterectomy for endometriosis by oophorectomy status. Am J Obstet Gynecol 2023; 228:57.e1.
Parazzini F, Bertulessi C, Pasini A, et al. Determinants of short term recurrence rate of endometriosis. Eur J Obstet Gynecol Reprod Biol 2005; 121:216.
Zheng Q, Mao H, Xu Y, et al. Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis. Arch Gynecol Obstet 2016; 294:201.
Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril 2014; 101:927.
Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open 2022; 2022:hoac009.
Shakiba K, Bena JF, McGill KM, ve diğerleri. Endometriozisin cerrahi tedavisi: daha fazla cerrahiye ihtiyaç duyulması üzerine 7 yıllık takip. Obstet Gynecol 2008; 111:1285.
Weir E, Mustard C, Cohen M, Kung R. Endometriosis: what is the risk of hospital admission, readmission, and major surgical intervention? J Minim Invasive Gynecol 2005; 12:486.
Maresh MJ, Metcalfe MA, McPherson K, et al. The VALUE national hysterectomy study: description of the patients and their surgery. BJOG 2002; 109:302.
Spilsbury K, Hammond I, Bulsara M, Semmens JB. Morbidity outcomes of 78,577 hysterectomies for benign reasons over 23 years. BJOG 2008; 115:1473.
MacDonald SR, Klock SC, Milad MP. Long-term outcome of nonconservative surgery (hysterectomy) for endometriosis-associated pain in women <30 years old. Am J Obstet Gynecol 1999; 180:1360.
Farquhar CM, Sadler L, Harvey SA, Stewart AW. The association of hysterectomy and menopause: a prospective cohort study. BJOG 2005; 112:956.
Moorman PG, Myers ER, Schildkraut JM, et al. Effect of hysterectomy with ovarian preservation on ovarian function. Obstet Gynecol 2011; 118:1271.
Halmesmäki K, Hurskainen R, Tiitinen A, et al. A randomized controlled trial of hysterectomy or levonorgestrel-releasing intrauterine system in the treatment of menorrhagia-effect on FSH levels and menopausal symptoms. Hum Reprod 2004; 19:378.
Kaiser R, Kusche M, Würz H. Hormone levels in women after hysterectomy. Arch Gynecol Obstet 1989; 244:169.
Oldenhave A, Jaszmann LJ, Everaerd WT, Haspels AA. Hysterectomized women with ovarian conservation report more severe climacteric complaints than do normal climacteric women of similar age. Am J Obstet Gynecol 1993; 168:765.
Siddle N, Sarrel P, Whitehead M. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril 1987; 47:94.
Riedel HH, Lehmann-Willenbrock E, Semm K. Ovarian failure phenomena after hysterectomy. J Reprod Med 1986; 31:597.
Namnoum AB, Hickman TN, Goodman SB, et al. Incidence of symptom recurrence after hysterectomy for endometriosis. Fertil Steril 1995; 64:898.
Farquhar CM, Harvey SA, Yu Y, et al. A prospective study of 3 years of outcomes after hysterectomy with and without oophorectomy. Am J Obstet Gynecol 2006; 194:711.
Parker WH, Broder MS, Chang E, et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses' health study. Obstet Gynecol 2009; 113:1027.
Jacoby VL, Grady D, Wactawski-Wende J, et al. Oophorectomy vs ovarian conservation with hysterectomy: cardiovascular disease, hip fracture, and cancer in the Women's Health Initiative Observational Study. Arch Intern Med 2011; 171:760.
Løkkegaard E, Jovanovic Z, Heitmann BL, et al. The association between early menopause and risk of ischaemic heart disease: influence of Hormone Therapy. Maturitas 2006; 53:226.
Rivera CM, Grossardt BR, Rhodes DJ, et al. Increased cardiovascular mortality after early bilateral oophorectomy. Menopause 2009; 16:15.
Shuster LT, Rhodes DJ, Gostout BS, et al. Premature menopause or early menopause: long-term health consequences. Maturitas 2010; 65:161.
Chapron C, Fauconnier A, Goffinet F, et al. Laparoscopic surgery is not inherently dangerous for patients presenting with benign gynaecologic pathology. Results of a meta-analysis. Hum Reprod 2002; 17:1334.
Crosignani PG, Vercellini P, Biffignandi F, et al. Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril 1996; 66:706.
Soto E, Luu TH, Liu X, et al. Laparoscopy vs. Robotic Surgery for Endometriosis (LAROSE): a multicenter, randomized, controlled trial. Fertil Steril 2017; 107:996.
Meuleman C, Tomassetti C, D'Hoore A, et al. Surgical treatment of deeply infiltrating endometriosis with colorectal involvement. Hum Reprod Update 2011; 17:311.
Young SW, Dahiya N, Yi J, et al. Impact of Uterine Sliding Sign in Routine United States Ultrasound Practice. J Ultrasound Med 2021; 40:1091.
Piessens S, Edwards A. Sonographic Evaluation for Endometriosis in Routine Pelvic Ultrasound. J Minim Invasive Gynecol 2020; 27:265.
Guerriero S, Condous G, van den Bosch T, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol 2016; 48:318.
Practice bulletin no. 114: management of endometriosis. Obstet Gynecol 2010; 116:223.
Yap C, Furness S, Farquhar C. Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev 2004; :CD003678.
ACOG Practice Bulletin No. 195: Prevention of Infection After Gynecologic Procedures. Obstet Gynecol 2018; 131:e172. Reaffirmed 2022.
Güenaga KF, Matos D, Wille-Jørgensen P. Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev 2011; :CD001544.
Demco L. Mapping the source and character of pain due to endometriosis by patient-assisted laparoscopy. J Am Assoc Gynecol Laparosc 1998; 5:241.
Parker JD, Sinaii N, Segars JH, et al. Adhesion formation after laparoscopic excision of endometriosis and lysis of adhesions. Fertil Steril 2005; 84:1457.
diZerega GS, Coad J, Donnez J. Clinical evaluation of endometriosis and differential response to surgical therapy with and without application of Oxiplex/AP* adhesion barrier gel. Fertil Steril 2007; 87:485.
Johnson NP, Hummelshoj L, World Endometriosis Society Montpellier Consortium. Consensus on current management of endometriosis. Hum Reprod 2013; 28:1552.
Zullo F, Palomba S, Zupi E, et al. Effectiveness of presacral neurectomy in women with severe dysmenorrhea caused by endometriosis who were treated with laparoscopic conservative surgery: a 1-year prospective randomized double-blind controlled trial. Am J Obstet Gynecol 2003; 189:5.
Zullo F, Palomba S, Zupi E, et al. Long-term effectiveness of presacral neurectomy for the treatment of severe dysmenorrhea due to endometriosis. J Am Assoc Gynecol Laparosc 2004; 11:23.
Johnson NP, Farquhar CM, Crossley S, et al. A double-blind randomised controlled trial of laparoscopic uterine nerve ablation for women with chronic pelvic pain. BJOG 2004; 111:950.
Daniels J, Gray R, Hills RK, et al. Laparoscopic uterosacral nerve ablation for alleviating chronic pelvic pain: a randomized controlled trial. JAMA 2009; 302:955.
Proctor ML, Latthe PM, Farquhar CM, et al. Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev 2005; :CD001896.
Duffy JM, Arambage K, Correa FJ, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2014; :CD011031.
Wheeler JM, Malinak LR. Recurrent endometriosis: incidence, management, and prognosis. Am J Obstet Gynecol 1983; 146:247.
Long AJ, Kaur P, Lukey A, et al. Reoperation and pain-related outcomes after hysterectomy for endometriosis by oophorectomy status. Am J Obstet Gynecol 2023; 228:57.e1.
Parazzini F, Bertulessi C, Pasini A, et al. Determinants of short term recurrence rate of endometriosis. Eur J Obstet Gynecol Reprod Biol 2005; 121:216.
Zheng Q, Mao H, Xu Y, et al. Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis. Arch Gynecol Obstet 2016; 294:201.
Sayfalar
81-86
Gelecek
21 Ocak 2025
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