Deeply infiltrating pelvic endometriosis: Histology and clinical significance

Cornillie, FJ; Oosterlynck, Didier J.; Lauweryns, J. M.; Koninckx, Philippe R.

doi:10.1016/0020-7292(91)90638-l

Cited by 130 publications

(180 citation statements)

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“…Cornillie et al 3 studied the relationship between depth of infiltration and pain in a series of 179 laparoscopies for pain, infertility or both. Implants were classified as superficial if they were #1 mm in depth, intermediate if 2±4 mm in depth and deep if they were $5 mm.…”

Section: Discussionmentioning

confidence: 99%

“…2 Endometriosis penetrating to $5 mm below the surface is considered to be deeply infiltrating. 3 However it was not until much later in the last century that the significance of this disease began to be appreciated. While initially thought to be inactive fibrotic tissue, deeply infiltrating endometriosis is now recognized to be a highly active manifestation of the disease, frequently associated with pelvic pain.…”

Section: Introductionmentioning

confidence: 99%

“…While initially thought to be inactive fibrotic tissue, deeply infiltrating endometriosis is now recognized to be a highly active manifestation of the disease, frequently associated with pelvic pain. 3,4 Deeply infiltrating endometriosis has been noted to occur mainly in the pouch of Douglas (55%), uterosacral ligaments (35%) and the uterovesical fold (11%). 3 Until recently, this condition frequently went unnoticed as the endometriosis may be entirely below the surface and better detected by pelvic examination and palpation with laparoscopic instruments rather than by laparoscopic inspection alone.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Deeply infiltrating endometriosis has been noted to occur mainly in the pouch of Douglas (55%), uterosacral ligaments (35%) and the uterovesical fold (11%). 3 Until recently, this condition frequently went unnoticed as the endometriosis may be entirely below the surface and better detected by pelvic examination and palpation with laparoscopic instruments rather than by laparoscopic inspection alone. However, the increasing awareness of the pathology of infiltrative endometriosis and the better visualization of the disease through advances in optics, illumination and high resolution cameras, have meant that gynaecologists have become better at making this diagnosis and also more comfortable about resecting deeply infiltrating endometriosis of the rectovaginal septum.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic resection of deeply infiltrating endometriosis of the rectovaginal septum: effect on pelvic pain

2001

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Objective To compare pain scores for dysmenorrhoea, intermenstrual pelvic pain, dyspareunia and dyschezia before and after resection of endometriotic nodules from the rectovaginal septum. Design Retrospective review of case records in 46 patients who had resection of deeply infiltrating endometriotic nodules from the rectovaginal septum. Adhesiolysis and treatment of endometriomas were performed where necessary. Two patients underwent laparoscopic uterosacral nerve ablation. Results The average patient age was 32 years. The presenting symptoms were: severe dysmenorrhoea (70%), pelvic pain (65%), dyspareunia (28%), dyschezia (30%) and infertility (28%). Improvements in pain scores at follow up (mean 8.8 months) were 59%, 87%, 77% and 86%. Only one of the 13 patients with infertility conceived in the follow‐up period. Conclusion This retrospective analysis suggests that the laparoscopic resection of rectovaginal endometriosis is effective in improving the different facets of pelvic pain. We believe that the development of a standardized scoring system to assess pain resulting from endometriosis would be helpful, as well as prospective studies to evaluate different treatment modalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic resection of deeply infiltrating endometriosis of the rectovaginal septum: effect on pelvic pain

2001

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“…Endometriosis is common affecting both fertile and infertile women. Deeply infiltrating endometriosis (DIE) is a specific entity that occurs in 30-40% of all patients with endometriosis [1]. Most DIE lesions are situated in the pelvis, and the intestine is affected in around one-fifth of the patients [2].…”

Section: Introductionmentioning

confidence: 99%