Current Challenges in the Diagnosis of Deep Infiltrating Endometriosis

Steven R. Lindheim, Tanya L. Glenn, Pascal Gagneux, Rose Maxwell, Yaklic JL, Austin D. Findley, Bala Bhagavath
In: Andrology & Gynecology: Current Research · 2018 · vol. 06(01) · doi:10.4172/2327-4360.1000162 · W2800749328
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Deep infiltrating endometriosis (DIE) diagnosis currently relies on invasive surgery, prompting research into less invasive biomarker-based diagnostic tools for earlier identification and treatment.

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This review article examines the diagnostic difficulties associated with deep infiltrating endometriosis, a severe form of the disease characterized by vague symptoms and a lack of specific criteria. The authors note that current diagnosis relies heavily on surgical confirmation, which is invasive and often delayed due to patient fear or provider reluctance, despite evidence that the condition is curable. While various classification systems based on imaging or symptoms have failed to provide reliable identification, recent research focuses on developing non-invasive biomarker tools using blood, urine, or tissue samples. This paper is centrally about endometriosis — specifically addressing the challenges in diagnosing its deep infiltrating subtype.

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Abstract

Deep infiltrating endometriosis (DIE) is a debilitating subset of endometriosis with an ill-defined set of symptoms and lacks specific diagnostic criteria to identify, leading to significant delays in treatment. Endometriosis itself is associated with chronic pain and infertility, leading to significant healthcare costs. A literature has shown that DIE is a non-progressive and curable disease. Currently, diagnosis is based purely on surgical diagnosis, which carriers a higher rate of morbidity, and fear of surgery or reluctance on behalf of provider, may delay diagnosis and thus treatment. Multiple attempts have been made to create an appropriate classification system mainly based on symptoms or imaging, however no one scheme has been successful to appropriately identify DIE. Research has now been geared towards the use of biomarkers, including blood, urine, peritoneal/follicular fluid, or endometrial tissue, to construct a diagnostic tool for DIE. This has the potential to create a less invasive mechanism for earlier identification and treatment of this curable disease.
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Research Article, Androl Gynecol Curr Res Vol: 6 Issue: 1 Current Challenges in the Diagnosis of Deep Infiltrating Endometriosis Steven R. Lindheim1*, Tanya Glenn1,3, Pascal Gagneux2, Rose A. Maxwell1, Yaklic JL1, Austin D. Findley1,3and Bala Bhagavath4 1Wright State University, Boonshoft School of Medicine, Department of Obstetrics and Gynecology, Ohio, USA 2Department of Cellular and Molecular Medicine, University of California San Diego, USA 3Wright-Patterson Medical Center, Department of Obstetrics and Gynecology, Wright-Patterson Air Force Base, Ohio, USA 4University of Rochester Medical Center, Division of Reproductive Endocrine Infertility, Department of Obstetrics and Gynecology, School of Medicine and Dentistry, New York, USA *Corresponding Author : Steven R. Lindheim Department of Obstetrics and Gynecology, Wright State University, Ohio, United States of America Tel: 858-740-1083 Fax: 937-222-7255 E-mail: [email protected] Received: February 28, 2018 Accepted: March 15, 2018 Published: March 20, 2018 Citation: Lindheim SR, Glenn T, Gagneux P, Maxwell RA, YaklicJL, et al. (2018) Current Challenges in the Diagnosis of Deep Infiltrating Endometriosis. Androl Gynecol: Curr Res 6:1. doi: 10.4172/2327-4360.1000162 Abstract Deep infiltrating endometriosis (DIE) is a debilitating subset of endometriosis with an ill-defined set of symptoms and lacks specific diagnostic criteria to identify, leading to significant delays in treatment. Endometriosis itself is associated with chronic pain and infertility, leading to significant healthcare costs. A literature has shown that DIE is a non-progressive and curable disease. Currently, diagnosis is based purely on surgical diagnosis, which carriers a higher rate of morbidity, and fear of surgery or reluctance on behalf of provider, may delay diagnosis and thus treatment. Multiple attempts have been made to create an appropriate classification system mainly based on symptoms or imaging, however no one scheme has been successful to appropriately identify DIE. Research has now been geared towards the use of biomarkers, including blood, urine, peritoneal/follicular fluid, or endometrial tissue, to construct a diagnostic tool for DIE. This has the potential to create a less invasive mechanism for earlier identification and treatment of this curable disease.

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