Deeply infiltrating disease in surgically treated endometriosis patients

Marjaleena Setälä, Hanna Savolainen, Jyrki Kössi, Tapio Ranta, Juha Mäkinen
Acta obstetricia et gynecologica Scandinavica · 2011 · vol. 90(5) , pp. 468–472 · doi:10.1111/j.1600-0412.2011.01097.x · PMID:21314818 · W1735652913
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This study found that deeply infiltrating endometriosis occurs in over half of surgically treated patients, particularly those with prior surgeries, pelvic pain, or a obliterated rectovaginal pouch.

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Abstract

Objective. To examine the incidence of deeply infiltrating endometriotic lesions among surgically treated endometriosis patients, and determine clinical parameters associated with the presence of deep disease. Design. Prospective observational study. Setting. Regional central hospital. Population. Patients undergoing surgical treatment of endometriosis. Methods. Complete excision of all visible endometriotic lesions and adhesions. Main Outcome Measures. The number and location of deep lesions, association between the presence of deep lesions, relevant preoperative and intraoperative factors. Results. Of 201 surgically treated endometriosis patients, 103 (51.2%) had deep lesions, 43.3% had uterosacral ligament deep lesions, 18.4% intestinal, 15.4% rectovaginal, and 3.5% urinary bladder deep lesions. Patients with deep lesions had more often undergone previous operations for endometriosis (p<0.01), had been operated on for pelvic pain (p<0.01) and had a totally obliterated rectovaginal pouch (p<0.01), compared to patients without deep lesions. In multivariate analysis, pelvic pain as an indication for surgery (OR 3.9, 95%CI 1.8–8.9, p<0.01) and totally obliterated rectovaginal pouch (OR 4.0, 95%CI 1.7–9.4, p<0.01) were independent prognostic factors for the presence of deep disease. Conclusions. Deeply infiltrating endometriosis is common in surgically treated endometriosis patients and should be searched for in those with persistent pelvic pain and where obliteration of the rectovaginal pouch is detected at surgery.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Adult Analysis of Variance Appendectomy Endometriosis Endometriosis Female Humans Hysterectomy Infertility Infertility Intestinal Diseases Intestinal Diseases Intestinal Diseases Middle Aged Ovarian Diseases Ovarian Diseases Ovarian Diseases Ovariectomy

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (29)

Cited by (10)

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