By Linda C. Giudice MD, Johannes L. H. Evers MD, David L. Healy
Written through an the world over famous editor staff, Endometriosis: technological know-how and perform is a state of the art consultant to this strangely universal sickness. whereas no reason for endometriosis has been decided, details of contemporary advancements are defined during this textual content, providing perception to enhance administration of indicators medically or surgically. the 1st of its variety, this significant textbook integrates clinical and medical figuring out of this painful sickness supporting to supply higher sufferer care.
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Additional info for Endometriosis: Science and Practice
2 Retrograde uretogogram showing intrinsic ureteric lesion. Courtesy of Mr Dinesh Agarwal. 3 (A) Laparoscopic dissection of vesical endometriosis. (B) Laparoscopic ureterolysis. Courtesy of Dr Weng Chan. 1 Segment of resected sigmoid colon with site of stricture due to endometriosis clearly visible. 2 Endometriosis on the right side of the diaphragm. 1 Induction of ovarian endometriotic-like lesions and peritoneal endometriosis by oncogenic K-rasG12D. (A) Activation of K-rasG12D within the ovarian surface epithelium (OSE) results in endometrioid glandular lesions (arrow); normal OSE is seen nearby (arrowhead).
Limitations of the rAFS classification include arbitrariness of the scoring system, limited reproducibility, failure to consider the morphological type of the lesion and a limited value of the system to aid in the evaluation and management in the setting of pelvic pain. These and other critical opinions led in 1997 to the publication of a Revised American Society for Reproductive Medicine classification of endometriosis: 1996 . Diversity of lesions Peritoneal endometriosis In the 1980s it became evident that peritoneal endometriosis has multiple appearances including microscopic foci, early-active (red, glandular or vesicular), advanced (black, puckered), and healed (white, fibrotic) forms.
Vercellini et al  analyzed the prevalence and severity of dysmenorrhea, intermenstrual pain and deep dyspareunia in relation to morphological features of peritoneal endometriosis. A statistically significant association was observed only with deep dyspareunia. Fresh, papular, atypical lesions might cause functional pain, whereas “old,” black nodules immersed in infiltrating scars might provoke mainly organic pain. Belasch et al  found a high prevalence of superficial endometriosis in biopsies from the uterosacral ligaments in both patients with chronic pelvic pain and asymptomatic (fertile and infertile) women.