Deep Pelvic Endometriosis A Multidisciplinary Approach
Deep pelvic endometriosis is one of the most severe expressions of a disease that may involve all the pelvic organs – bladder, ureters, rectosigmoid colon – causing debilitating symptoms and leading to impaired quality of life in young women. The chapters
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Paola De Nardi • Stefano Ferrari
Deep Pelvic Endometriosis A Multidisciplinary Approach
With the contribution of Elaine Denny
Foreword by Massimo Candiani
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Authors Paola De Nardi Department of Surgery San Raffaele Scientific Institute Milan, Italy Stefano Ferrari Department of Obstetrics and Gynaecology San Raffaele Scientific Institute Milan, Italy With the contribution of: Elaine Denny Professor of Health Sociology Faculty of Health Birmingham City University Birmingham, UK
ISBN 978-88-470-1865-5
e-ISBN 978-88-470-1866-2
DOI 10.1007/978-88-470-1866-2 Springer Milan Dordrecht Heidelberg London New York Library of Congress Control Number: 2010939273 © Springer-Verlag Italia 2011 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the Italian Copyright Law in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the Italian Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. 9 8 7 6 5 4 3 2 1 Cover design: Ikona s.r.l., Milan, Italy Typesetting: Graphostudio, Milan, Italy Printing and binding: Arti Grafiche Nidasio, Assago (MI), Italy Printed in Italy Springer-Verlag Italia S.r.l. – Via Decembrio 28 – I-20137 Milan Springer is a part of Springer Science+Business Media (www.springer.com)
Foreword
Deep endometriosis was identified by Cullen at the beginning of the last century, as a nodular lesion that is able to invade the rectovaginal space, the uterine ligaments, the wall of the bowel, and the ovary. Indeed, Cullen made a great contribution to progress in the field of defining and describing deeply invasive lesions, while Sampson was the first to describe superficial lesions with little or no associated smooth muscle metaplasia, minor symptoms, and fewer structural changes in the pelvis. Deep infiltrating endometriosis (DIE) is currently a specific entity defined by the presence of an endometriotic lesion that extends more than 5 mm below the peritoneum and includes infiltrative forms that involve vital structures such as the bowel, ureters, and bladder. Some aspects of this condition have yet to be elucidated. The pathogenesis of this disorder has long been a source of debate, since some authors support its origin from previous Müllerian remnant
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