Habib Nassir, Centini Gabriele, Lazzeri Lucia, Amoruso Nicola, El Khoury Lionel, Zupi Errico, Afors Karolina
Department of Obstetrics and Gynaecology, Beaujon Hospital-University of Paris, Clichy Cedex 92110, France.
Department of Molecular and Developmental Medicine, University of Siena, Ospedale Santa Maria alle Scotte, Siena 53100, Italy.
Int J Womens Health. 2020 Jan 29;12:35-47. doi: 10.2147/IJWH.S190326. eCollection 2020.
Endometriosis is a chronic condition primarily affecting young women of reproductive age. Although some women with bowel endometriosis may be asymptomatic patients typically report a myriad of symptoms such as alteration in bowel habits (constipation/diarrhoea) dyschezia, dysmenorrhoea and dyspareunia in addition to infertility. To date, there are no clear guidelines on the evaluation of patients with suspected bowel endometriosis. Several techniques have been proposed including transvaginal and/or transrectal ultrasonography, magnetic resonance imaging, and double-contrast barium enema. These different imaging modalities provide greater information regarding presence, location and extent of endometriosis ensuring patients are adequately informed whilst also optimizing preoperative planning. In cases where surgical management is indicated, surgery should be performed by experienced surgeons, in centres with access to multidisciplinary care. Treatment should be tailored according to patient symptoms and wishes with a view to excising as much disease as possible, whilst at the same time preserving organ function. In this review article current perspectives on diagnosis and management of bowel endometriosis are discussed.
子宫内膜异位症是一种主要影响育龄期年轻女性的慢性疾病。虽然一些患有肠道子宫内膜异位症的女性可能没有症状，但患者通常会报告多种症状，如排便习惯改变（便秘/腹泻）、排便困难、痛经、性交困难以及不孕。迄今为止，对于疑似肠道子宫内膜异位症患者的评估尚无明确指南。已经提出了几种技术，包括经阴道和/或经直肠超声检查、磁共振成像以及双重对比钡剂灌肠。这些不同的成像方式提供了有关子宫内膜异位症的存在、位置和范围的更多信息，确保患者得到充分告知，同时优化术前规划。在需要进行手术治疗的情况下，应由经验丰富的外科医生在能够提供多学科护理的中心进行手术。治疗应根据患者的症状和意愿进行调整，以期尽可能切除更多病灶，同时保留器官功能。在这篇综述文章中，讨论了肠道子宫内膜异位症诊断和管理的当前观点。
