Chapron C, Dubuisson J B, Chopin N, Foulot H, Jacob S, Vieira M, Barakat H, Fauconnier A
Service de gynécologie obstétrique II, unité de chirurgie gynécologique, clinique universitaire Baudelocque, CHU Cochin-Saint-Vincent-de-Paul, 123, boulevard de Port-Royal, 75014 Paris, France.
Gynecol Obstet Fertil. 2003 Mar;31(3):197-206. doi: 10.1016/s1297-9589(03)00045-6.
Deep pelvic endometriosis presents essentially in the form of a painful syndrome dominated by deep dyspareunia and painful functional symptoms that recur according to the menstrual cycle, with the semiology directly correlated with the location of the lesions (bladder, rectum). It is essential to investigate these deep endometriosis lesions and draw up a precise map, which is the only way to be sure that exeresis will be complete. The treatment of first intention remains surgery, and medical treatment is only palliative in the majority of cases. Success of treatment depends on how radical surgical exeresis is. Based on analysis of the anatomical distribution of deep pelvic endometriosis lesions, a "surgical classification" is proposed with the aim of establishing standard modes for surgical treatment. Further studies are required to clarify the place and modes for pre- and postoperative medical treatment.
深部盆腔子宫内膜异位症主要表现为一种以深部性交困难和与月经周期相关的复发性疼痛功能症状为主的疼痛综合征,其症状学与病变部位(膀胱、直肠)直接相关。对这些深部子宫内膜异位症病变进行检查并绘制精确的图谱至关重要,这是确保切除彻底的唯一方法。首选治疗方法仍然是手术,在大多数情况下,药物治疗仅起姑息作用。治疗的成功取决于手术切除的彻底程度。基于对深部盆腔子宫内膜异位症病变解剖分布的分析,提出了一种“手术分类”方法,旨在建立标准的手术治疗模式。需要进一步研究以明确术前和术后药物治疗的地位和方式。