Cystic and Deep Endometriosis: From diagnosis to innovations in surgery

Endometriosis can be present in several forms – peritoneal, cystic-ovarian and deep – and causes pelvic pain and infertility. This clinical PhD project will focus on cystic and deep endometriosis. First, diagnostic evaluation and classification of deep disease will be studied in a prospective trial evaluating the performance of gynecological ultrasound in predicting endometriosis extent and invasion depth in women scheduled for endometriosis surgery. Second, a prospective controlled study will be performed in patients undergoing surgery for deep and/or cystic disease. A first part of this study will – in women with cystic (with or without deep) disease – evaluate the effect of various surgical techniques on ovarian reserve. A second part of this study – in women with deep disease involving the rectosigmoid – will assess the effect of various surgical techniques for bowel endometriosis on postoperative pain, bowel/urological function and recurrence (both short and long term). In this prospective controlled study, collaboration with ongoing biomarker studies in endometriosis is foreseen. Third, a retrospective study on the use of the Endometriosis Fertility Index in the Leuven University Fertility Center will be performed. In summary, this clinical PhD project will cover the more severe forms of endometriosis with regards to recent innovations in diagnosis, surgical treatment and postoperative fertility management.