Preserving fertility by treating the three compartments: laparoscopic approach to deep infiltrating endometriosis (original) (raw)

Journal of minimally invasive gynecology, 2018

Abstract

To describe a laparoscopic technique for the resection of deep endometriosis, treating the three compartments. Educational video SETTING: Tertiary referral center in Strasbourg, France PATIENTS: This is the case of a 37-year-old primiparous woman. Her main symptoms included dysmenorrhea and dyspareunia associated with pollakiuria and macroscopic menstrual hematuria (with emission of endometriotic tissue on analysis). She also complained of dyschezia. The MRI revealed an endometriotic nodule in the vesicouterine space with an involvement of the anterior wall of the uterus and a suspicion of bladder adenomyosis. There are lateral spicules attracting the ovaries towards the midline and an infiltration of the round ligaments and nodules related to the rectovaginal space's endometriosis. A possible invasion is noted underneath the rectal mucosa. The patient wants to preserve her fertility. Adenomyomectomy, partial cystectomy, and bowel resection. Fertility preservation is mandatory d...

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