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- Title
Postoperative imaging findings after laparoscopic surgery for deeply infiltrating endometriosis.
- Authors
Chamié, Luciana P.; Ribeiro, Duarte M. F. R.; Ribeiro, Gladis M. P. A. R.; Serafini, Paulo C.
- Abstract
Deeply infiltrative endometriosis (DIE) is a common gynecologic disease affecting women of reproductive age and often causing chronic pelvic pain and infertility. Clinical treatment options and preventive actions are ineffective due to the lack of knowledge about the etiology of DIE. Surgical treatment is currently the only alternative to eradicate the disease. Diagnostic imaging plays a crucial role for surgical planning and postoperative evaluation. Transvaginal sonography (TVS) with a dedicated protocol and magnetic resonance imaging (MRI) can be used to evaluate recurrent disease. Extensive pelvic surgery may cause anatomical changes and a variable spectrum of postoperative findings. Residual disease and complications can be also evaluated and are of great importance to estimate pain relief and fertility prognosis. The most common imaging findings following radical surgery for DIE are fibrotic scars in the retrocervical space and bowel anastomosis, absence of the posterior vaginal fornix and loculated fluid in the pararectal spaces. Ovaries are the most frequent site of early recurrence. Complications include infection, hemorrhage, urinary/evacuatory voiding dysfunctions as well as bowel and ureteral stenosis. The purpose of this article is to review the surgical techniques currently used to treat endometriosis in the retrocervical space, vagina, bladder, bowel, ureters, and ovaries and to describe the most common imaging findings including normal aspects, residual disease, complications, and recurrence.
- Subjects
PELVIC pain; LAPAROSCOPIC surgery; TRANSVAGINAL ultrasonography; MAGNETIC resonance imaging; DISEASE complications; TRANSVERSUS abdominis muscle; URINATION disorders; LONGITUDINAL ligaments
- Publication
Abdominal Radiology, 2020, Vol 45, Issue 6, p1847
- ISSN
2366-004X
- Publication type
Article
- DOI
10.1007/s00261-020-02434-5