Laparoscopic treatment of bowel endometriosis in infertile women
Abstract
Background The purpose of the study was to determine the influence of bowel endometriosis on fertility, and to study whether its removal improves fecundity in women with endometriosis-associated infertility. Methods Three groups of infertile patients were included in the study. Group A (60 women) consisted of patients who underwent surgery for endometriosis with colorectal segmental resection. In group B, 40 patients with evidence of bowel endometriosis underwent endometriosis removal without bowel resection. Group C consisted of 55 women who underwent surgery for moderate or severe endometriosis with at least one endometrioma and deep infiltrating endometriosis but without bowel involvement. The women were clinically evaluated before laparoscopy and then at 1 month, at 6 months and at each year up to 4 years after surgery. Main outcome measures were surgical complications as well as post-operative pregnancy rate, time to conception and monthly fecundity rate. Results The monthly fecundity rates (MFR) in groups A, B and C were 2.3, 0.84 and 3.95%, respectively. The difference in the MFR between groups was significant (P Conclusions The presence of bowel infiltration by endometriosis seems to negatively influence the reproductive outcome in women with endometriosis-associated infertility. The complete removal of endometriosis with bowel segmental resection seems to offer better results in terms of post-operative fertility.
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At the authors' institution, in the last 7 years, 789 laparoscopic bowel resections for 307 severe endometrioses have been performed.
“At our institution, in the last 7 years, 789 laparoscopic bowel resections for 307 severe endometrioses have been performed [47, 25–27, 45–48].”
Endometriosis has an "onco-mimetic nature", which reflects in many aspects the clinico pathological features of ovarian cancer.
“As can be easily shown in this case and in our series, endometriosis has in fact an “onco-mimetic nature”, which reflects in many aspects the clinico pathological features of ovarian cancer [25–27, 45–48].”
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Surgical treatment of deeply infiltrating endometriosis with colorectal involvement
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“At our institution, in the last 7 years, 789 laparoscopic bowel resections for 307 severe endometrioses have been performed [47, 25-27, 45-48].”
MethodResultSelf-citationCeccaroni, M., Clarizia, R., Mussi, E. A., Stepniewska, A. K., De Mitri, P., Ceccarello, M., Ruffo, G., Bruni, F., Rettore, L., & Surico, D. (2022) · Surgical Endoscopy · doi:10.1007/s00464-021-08663-z · Cited by 13 · see citing works
Self-citationFujii, M., Koshiba, A., Ito, F., Kusuki, I., Kitawaki, J., & Mori, T. (2023) · Gynecology and Minimally Invasive Therapy · doi:10.4103/gmit.gmit_132_22 · Cited by 3 · see citing works
- Authors
- Stepniewska, A., Pomini, P., Bruni, F., Mereu, L., Ruffo, G., Ceccaroni, M., Scioscia, M., Guerriero, M., & Minelli, L.
- Affiliations
- University of Verona (IT)
- Corresponding author
- Stepniewska, A.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-04-08
- Volume
- 24
- Issue
- 7
- Pages
- 1619-1625
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2156177799
- Cited by
- 146
- References
- 3
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 8 · 2023: 3 · 2022: 11 · 2021: 9 · 2020: 9 · 2019: 4 · 2018: 5 · 2017: 12 · 2016: 9 · 2015: 10 · 2014: 13 · 2013: 9 · 2012: 10
- FWCI
- 13.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- bowel endometriosis, endometriosis-associated infertility, laparoscopic surgery, segmentectomy, fecundity, postoperative pregnancy rate, time to conception, endometrioma, deep infiltrating endometriosis, surgical complications
- MeSH terms
- Endometriosis, Female, Fertility, Follow-Up Studies, Humans, Infertility, Female, Infertility, Male, Intestines, Male, Laparoscopy, Pregnancy, Pregnancy Outcome, Prospective Studies, Time Factors, Treatment Outcome
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