**6. Conclusion**

Three typical characteristics of perineal endometriosis for women of reproductive ages include: (1) past perineal tearing of episiotomy during vaginal delivery; (2) a tender nodule or mass at the perineal lesion; and (3) progressive and cyclic perineal pain. If these 3 criteria were met, the predictive value of perineal endometriosis was 100% (Zhu et al., 2009). Based on these two studies of patients of perineal endometriosis in our hospital, Lan Zhu et al. suggests complete excision of the endometrioma is the first choice of treatment for perineal endometriosis (Zhu et al., 2009). When the perineal endometrioma invades into anal sphincter, we recommend NE and PSp with preoperative hormonal therapy as an appropriate treatment.

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**4** 

*Spain* 

**Abdominopelvic Complications** 

*Department of General Surgery, Hospital de Antequera, Málaga,* 

Endometriosis is a painful chronic disease occurring in 4 to 17% of menstruating women. Its aetiology is unknown, although there is a high incidence in sterile females (10-25%) (Pritts *et al.*, 2003), 60-70% in women with chronic pelvis pain as well as in those who have a family history (Bianchi *et al.*, 2007). It is characterized by the presence of functional endometrial

Endometriosis can be divided into intra and extraperitoneal sites. The intraperitoneal locations are ovaries (30%), uterosacral and large ligaments (18-24%), fallopian tubes (20%), pelvic peritoneum, pouch of Douglas and gastrointestinal tract. Extraperitoneal locations include cervical portio (0.5%), vagina and rectovaginal septum, round ligament, inguinal hernia sac, abdominal scars after gynaecological surgery (1.5%) and caesarean section (0.5%). This disease rarely affects extra-abdominal organs such as the lungs, urinary system,

Clinical manifestations of endometriosis fall into three general categories: pelvic pain, infertility and pelvis mass. The goal of therapy is to relieve these symptoms. There is no high quality evidence that one medical therapy is superior to another for managing pelvic pain due to endometriosis, or that any type of medical treatment will affect future fertility. Therefore, treatment decisions are individualized, taking into account the severity of symptoms, the extent and location of disease, desire for pregnancy, the age of the patient, medication side effects, surgical complication rates, and cost (Berlanda *et al.*, 2010; Shakiba *et* 


skin and the central nervous system (Chapron *et al.*, 2003; Veeraswamy *et al.*, 2010).

tissue consisting of glands and/or stroma located outside the uterus.

**2. General indications for surgery of endometriosis**  Indications for surgical management of endometriosis include:



obstruction of the bowel or urinary tract, etc.


**1. Introduction** 

*al.,* 2008).

**of Endometriosis** 

Arturo del Rey-Moreno

Zhu Lan, Lang Jinghe & Wang Hanbi, et al. (2009). Presentation and management of perineal endometriosis. *Int J Gynaecol Obstet*, Vol.105, No.3, (Jun 2009), pp. 230-232, ISSN 0020-7292
