Surgical treatment of endometriosis

Endometrioza je kronična ginekološka bolest koja se javlja u žena reproduktivne dobi, a glavni simptomi kojima se bolest očituje su dismenoreja, dispareunija i smetnje plodnosti. Endometriozu karakterizira prisustvo tkiva endometrija izvan maternice, a ono raste pod utjecajem estrogena. Točan mehanizam nastanka i prevalencija ove bolesti nisu poznati. Dijagnoza se postavlja uzimanjem anamneze, kliničkim pregledom i pretragama kao što su ultrazvuk i magnetska rezonanca, a zlatni standard predstavlja laparoskopska vizualizacija lezija uz patohistološku analizu. Terapijske mogućnosti uključuju medikamentno, kirurško i kombinirano liječenje, dok se neplodnost povezana s endometriozom liječi metodama potpomognute oplodnje. Kirurško liječenje dolazi u obzir u pacijentica koje ne odgovaraju na medikamentnu terapiju, koje imaju proširenu bolest i žele očuvati reproduktivnu sposobnost, a većinom se izvodi laparoskopski. Ne postoje jasne smjernice koje bi dale prednost nekoj od ovih terapijskih mogućnosti, stoga je pri odlučivanju potreban individualan pristup prema svakoj pacijentici.Endometriosis is a chronic gynecological disease that primarily affects women of reproductive age. Its main symptoms are dysmenorrhea, dyspareunia, and fertility problems. Endometriosis is characterized by the presence of endometrial tissue outside the uterus, which grows under the influence of estrogen. The exact mechanism of development and the prevalence of this disease are not yet fully understood. Diagnosis involves a thorough medical history, clinical examination and diagnostic tests such as ultrasound and magnetic resonance imaging (MRI), while the gold standard is laparoscopic visualization of lesions, followed by histopathological analysis. Therapeutic options include medical, surgical, and combined treatment, while infertility associated with endometriosis is treated with assisted reproductive techniques. Surgical treatment may be considered for patients who do not respond to medical therapy, have extensive disease, and wish to preserve their reproductive ability, with laparoscopy being the most common approach. There are no clear guidelines favoring one of these therapeutic options, so an individualized approach is necessary, taking into consideration the patient's symptoms, disease severity, reproductive goals, and overall health