Deep infiltrative endometriosis. Contentious issues: pros and cons

Elena I. Rusina, Maria I. Yarmolinskaya, Valeriia O. Piankova
In: Gynecology · 2020 · vol. 22(5) , pp. 50–56 · doi:10.26442/20795696.2020.5.200274 · W3109072432
article OA: gold CC0 ⤵ 4 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This review examines debated issues in deep infiltrative endometriosis pathogenesis and management, analyzing data on pain, infertility, and treatment options, recommending personalized strategies for this chronic, recurrent disease.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This review examines debated issues in the pathogenesis and management of deep infiltrative endometriosis (DIE) using foreign and domestic scientific articles indexed in PubMed and available online over the prior 5 years, focusing on pain, infertility, and conservative versus surgical management choices. It synthesizes evidence that DIE may represent a distinct phenotype with enhanced invasion-related processes, dysregulated immune activity (including altered cytokines in peritoneal fluid), and proposed diagnostic or prognostic biomarkers such as CD15 expression in endometrial biopsies and anti–GM-CSF antibodies linked to disease severity; it also describes multifactorial mechanisms of pain and the multifactorial nature of infertility, including common coexisting ovarian endometriosis and inflammatory/adhesive effects. The review’s major limitation is that it is based on literature system analysis rather than new experimental or trial outcomes. It relates to endometriosis directly by being centrally about deep infiltrative endometriosis and also discusses possible shared origins between adenomyosis and DIE.

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Abstract

Relevance.Deep infiltrative endometriosis (DIE) is a particular form of endometriosis with a more severe symptoms and dysfunction of the neighboring organs. Inspite of the fact that in recent years, much had been done to understand the pathogenesis of the disease and its associated symptoms; there are still several unresolved issues. Aim.To describe debated issues of pathogenesis and management of patients with DIE using current data. Materials and methods. Foreign and domestic scientific articles on this topic that is available in PubMed database and on Internet resources have been examined over the past 5 years. Results.The review consisted of a system analysis of data on the pathogenesis of pain, infertility, the choice of conservative or surgical treatment in dealing with specific problems of managing patients with DIE. Conclusion.Despite there are different options of managing and treating, most specialists agree that the treatment strategy should be based on the assumption that it is a chronic recurrent disease. The treatment choice should be personal depending on the severity of symptoms, dysfunction of the neighboring organs affected by endometriosis, such as the intestines, bladder, ureters, as well as the womans age and reproductive life plans. Depending on the clinical case, it is possible to use various regimens of conservative management. Surgical management planning should be highly balanced. A radical surgery with removing foci of endometriosis performed by an experienced surgeon in a specialized hospital in coupled with pharmacotherapy and assisted reproductive technologies increases the patients chances of pregnancy, a healthy childbearing. Subsequent combination therapy provides a long-term remission. Pregnancy and childbirth in patients with deep infiltrative endometriosis should be considered as a high risk condition for the severe complications.

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Condition tags

endometriosisdie_deep_infiltratinginfertility

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