Charatsi Dimitra, Koukoura Ourania, Ntavela Irontianta Gkorezi, Chintziou Foteini, Gkorila Georgia, Tsagkoulis Manthos, Mikos Themistoklis, Pistofidis George, Hajiioannou Jiannis, Daponte Alexandros
Department of Obstetrics and Gynecology, University Hospital of Larissa, Thessaly, Larissa, Greece.
1st Department of Obstetrics & Gynecology, Aristotle University of Thessaloniki, Papagheorgiou General Hospital, Thessaloniki, Greece.
Adv Med. 2018 Sep 26;2018:3461209. doi: 10.1155/2018/3461209. eCollection 2018.
Extrapelvic endometriosis is a rare entity that presents serious challenges to researchers and clinicians. Endometriotic lesions have been reported in every part of the female human body and in some instances in males. Organs that are close to the uterus are more often affected than distant locations. Extrapelvic endometriosis affects a slightly older population of women than pelvic endometriosis. This might lead to the assumption that it takes several years for pelvic endometriosis to "metastasize" outside the pelvis. All current theories of the pathophysiology of endometriosis apply to some extent to the different types of extrapelvic endometriosis. The gastrointestinal tract is the most common location of extrapelvic endometriosis with the urinary system being the second one. However, since sigmoid colon, rectum, and bladder are pelvic organs, extragenital pelvic endometriosis may be a more suitable definition for endometriotic implants related to these organs than extrapelvic endometriosis. The sigmoid colon is the most commonly involved, followed by the rectum, ileum, appendix, and caecum. Most lesions are confined in the serosal layer; however, deeper lesion can alter bowel function and cause symptoms. Bladder and ureteral involvement are the most common sites concerning the urinary system. Unfortunately, ureteral endometriosis is often asymptomatic leading to silent obstructive uropathy and renal failure. Surgical excision of the endometriotic tissue is the ideal treatment for all types of extrapelvic endometriosis. Adjunctive treatment might be useful in selected cases.
盆腔外子宫内膜异位症是一种罕见的疾病，给研究人员和临床医生带来了严峻挑战。子宫内膜异位症病变已在女性人体的各个部位被报道，在某些情况下也见于男性。靠近子宫的器官比远处器官更常受累。盆腔外子宫内膜异位症患者的年龄略大于盆腔子宫内膜异位症患者。这可能导致一种假设，即盆腔子宫内膜异位症需要数年时间才会“转移”到盆腔外。目前所有关于子宫内膜异位症病理生理学的理论在一定程度上都适用于不同类型的盆腔外子宫内膜异位症。胃肠道是盆腔外子宫内膜异位症最常见的发病部位，泌尿系统次之。然而，由于乙状结肠、直肠和膀胱是盆腔器官，对于与这些器官相关的子宫内膜异位植入物，生殖器外盆腔子宫内膜异位症可能是比盆腔外子宫内膜异位症更合适的定义。乙状结肠是最常受累的部位，其次是直肠、回肠、阑尾和盲肠。大多数病变局限于浆膜层；然而，较深的病变会改变肠道功能并引起症状。膀胱和输尿管受累是泌尿系统最常见的部位。不幸的是，输尿管子宫内膜异位症通常无症状，会导致隐匿性梗阻性肾病和肾衰竭。手术切除子宫内膜异位组织是所有类型盆腔外子宫内膜异位症的理想治疗方法。在某些特定情况下，辅助治疗可能会有帮助。
