Urological aspects of advanced endometriosis

Endometriosis, or endometrioid disease, ranks third in the structure of gynecological morbidity and is considered a significant medical and social problem. In advanced endometriosis, adjacent organs and systems become involved, leading to functional impairments and, in some cases, complete loss of function and disability in young women. The article highlights the clinical course, variability of symptoms, and diagnostic challenges in patients with deep infiltrative endometriosis. A review of both domestic and international literature was conducted using such search engines as eLibrary.ru, Scopus, and PubMed. The article also presents clinical cases of deep infiltrative endometriosis. With the voluntary informed consent of the patients, an analysis of medical records, clinical history, laboratory and instrumental examination results, and surgical treatment protocols was conducted. Endometriosis is a disease of women of reproductive age. In our observations, the youngest patient was 19 years old, and the oldest was 37 years old. This is consistent with the data from domestic and international sources, indicating that patients suffering from external genital or extragenital endometriosis are usually young women, with the onset of the disease long before the appearance of symptoms. The average age of becoming a mother for the first time in various regions of the Russian Federation in 2019 was 25.9 years. If this trend continues, women will develop endometriosis before having their first child. Patients with deep infiltrative endometriosis require a specialized, multidisciplinary approach to diagnosis and treatment of their condition involving a gynecologist, urologist, and surgeon.