Severe, Deep Endometriosis that affect different organs (Bladder, intestines)

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A categorization made by Markham separates endometriosis that extend out from pelvis into four main groups:

  1. Gastrointestinal System

  2. Urinary System

  3. Thoracic Cavity

  4. Other organs including skin and nervous system

Gastrointestinal system is most commonly affected from extrapelvic endometriosis. Intestinal affection is seen in %3-15 of women and this rate goes up to %50 in severe endometriosis cases. Rectum and sigmoid colon is most commonly affected. Diarrhea and constipation periods, anal pain and dyspareunia are common symptoms. Almost one third of these women suffer from cyclic anal bleeding. Here, you may see MRI image (R=uterus, *=endometrioma inside intestines) and picture of endometriosis in intestines during removal in operation (R=uterus). This patient was operated laparoscopicly for two times but disease reoccurred because it could not be removed.

Prof. Dr. Süleyman Engin Akhan

Prof. Dr. Süleyman Engin Akhan

Urinary tract is the second most common location of extrapelvis endometriosis and it takes %2 and 4 of all the cases. %50 of patients who have endometriosis in urinary tracts have a history of pelvic surgery (including cesarean). Bladder is the most commonly affected organ in urinary system. Bladder affection is around %80-90. Here, you may see a picture of endometriosis I removed from urinary bladder (E=Endometriosis)

Prof. Dr. Süleyman Engin Akhan

Endometriosis seen in uterine anomalies

I don’t want to tell this topic in detail, in patients with congenital uterine anomalies, for example double uterus or one-sided uterus, menstrual blood cannot be emptied and it leaks into the abdomen. In these patients, frequency of intraabdominal endometriosis and endometrioma increases.