Deep endometriosis: clinical and epidemiological findings of diagnosed women according to the criteria of the international deep endometriosis analysis group (IDEA)

Cicília Fraga Rocha Pontes Fernandez, Luciana Pardini Chamié, Mauro Monteiro de Aguiar, Eduardo Just da Costa e Silva, Débora F. Leite, Simone Angélica Leite de Carvalho Silva, José Luiz de Figueiredo
In: Journal of Human Growth and Development · 2022 · vol. 32(2) , pp. 223–231 · doi:10.36311/jhgd.v32.13312 · W4283738710
article OA: diamond CC0 ⤵ 4 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study analyzed 227 women with ultrasound-diagnosed deep endometriosis, finding high prevalences of infertility and painful symptoms, alongside frequent prior surgeries and low rates of pelvic physiotherapy.

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

This cross-sectional study analyzed 227 women with ultrasound-diagnosed deep endometriosis using transvaginal pelvic ultrasound with bowel preparation (TVUBP) based on the IDEA criteria, characterizing clinical and epidemiological profiles. The authors found that infertility was present in 43.8% of participants, and painful symptoms were common, including dysmenorrhea in 84.7% (mean VAS 6.9), dyspareunia in 69.1% (mean VAS 4.2), menstrual dyschezia in 60.7% (mean VAS 4.3), and menstrual dysuria in 35.7%. The paper notes a major limitation that prior deep endometriosis data were often drawn from surgery-selected cohorts, raising selection bias, and it also reports low utilization of pelvic floor physiotherapy (6.8%) despite an “ideal treatment recommendations” framework. This paper is centrally about endometriosis — it reports the clinical and epidemiological findings of women with deep endometriosis diagnosed via TVUBP using IDEA criteria.

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Abstract

Introduction: endometriosis occurs when tissue similar to the endometrium affects the peritoneum, which can infiltrate structures and organs such as the bowel, ureter, bladder or vagina and is usually accompanied by an inflammatory process. It is estimated that the disease affects 6 to 10% of women of reproductive age and more than 50% of infertile women. The clinical and epidemiological data of patients with DE come from studies whose women were selected by surgery, therefore subject to selection bias. Transvaginal pelvic ultrasound with bowel preparation (TVUBP) has high specificity and sensitivity values. Objective: analyze the clinical and epidemiological profile of patients with DE diagnosed through the TVUBP. Methods: a cross-sectional study that analyzed 227 patients with an ultrasound diagnosis of deep endometriosis. Results: infertility affected 43.8% of women. Painful symptoms considered as moderate or severe (visual analogue scale, VAS, >3) had the following prevalence and mean values on the VAS scale, respectively: dysmenorrhea in 84.7% (6.9), dyspareunia in 69.1%, (4.2) menstrual dyschezia in 60.7% (4.3) and menstrual dysuria in 35.7% of patients. A history of multiple surgeries occurred in 10.4% and only 6.8% of patients had undergone physiotherapy for the pelvic floor. Conclusion: the DE population had a high prevalence of infertility and pain symptoms, findings that reflect the social impact on the quality of life and family planning of these women. The high frequency of history of multiple surgical approaches and the low incidence of history of pelvic physiotherapy in the population with DE, contrary to the currently established ideal treatment recommendations, indicate the difficulty of access for patients to specialized centers.

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VAS-pain

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endometriosisdysmenorrheadyspareuniainfertility

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