Management of Deep Endometriosis
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This paper details diagnostic methods including EUS, MRI, and transvaginal ultrasonography, and surgical approaches for managing deep endometriosis, defined as lesions penetrating >5 mm into the retroperitoneal space.
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Abstract
Deep endometriosis is defined as an endometriotic lesion that penetrates the retroperitoneal space for a distance of > or =5 mm. Deep endometriosis is extremely active, occurs in phase with eutopic endometrium, evolves progressively with age, and is most often located in the pouch of Douglas, the rectovaginal septum, the uterosacral ligaments, and occasionally in the uterovesical fold. These lesions are associated with pelvic pain, the intensity of which is proportional to the depth of penetration. It is clear that choice of treatment depends on the location of the endometriotic lesion. In this paper we describe our methods for the initial diagnosis and subsequent treatment of deep endometriosis. These include consultation and clinical examination protocols, use of rectal endoscopic ultrasonography (EUS), magnetic resonance imaging (MRI), and transvaginal ultrasonography techniques in diagnosis and surgical treatment approaches.
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Cited by (46)
- Dolor pélvico crónico en la mujer 2025
- Impact of dietary patterns on pain and quality of life in ovarian and deep endometriosis: observational study for nutritional interventions 2025
- Douleurs pelviennes chroniques de la femme 2025
- Serial assessment of inflammatory parameters for prediction of septic complications following surgery for colorectal endometriosis 2021
- Accuracy of sonography for non‐invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study 2021
- Association between disease extent and pain symptoms in patients with deep infiltrating endometriosis 2019
- Surgical laparoscopic treatment of bowel endometriosis with transvaginal resection of the rectum using ultrasonically activated shears: a retrospective cohort study with description of technique 2018
- Sonographic evaluation of deep endometriosis: protocol for a US radiology practice 2016
- Susceptibility-weighted magnetic resonance imaging for the evaluation of deep infiltrating endometriosis: preliminary results 2015
- Experience with multidisciplinary laparoscopic surgery in patients with deep infiltrating colorectal endometriosis 2014
- Endometriosis profunda. Desafío ac- tual para el ultrasonografista. Revisión de la literatura y casos clínicos 2012
- Deeply infiltrating endometriosis: Evaluation of retro-cervical space on MRI after vaginal opacification 2011
- Is Pouch of Douglas Obliteration a Marker of Bowel Endometriosis? 2011
- Laparoscopic Rectal Resection of Deep Infiltrating Endometriosis 2011
- Treatment 2011
- Deep rectosigmoid endometriosis: “mushroom cap” sign on T2-weighted MR imaging 2010
- Laparoscopic Excision of Endometriosis May Require Unilateral Parametrectomy 2009
- Laparoscopic Treatment of Deep Pelvic Endometriosis with Rectal Involvement 2009
- NOVEL SURGICAL APPROACH TARGETING CHRONIC PELVIC PAIN WITH J-PLASMA® 2009
- Severe endometriosis: laparoscopic rectum resection 2009
- Importância da ultra-sonografia anorretal tridimensional na decisão terapêutica da endometriose profunda 2009
- Valor do enema de bário com duplo contraste no diagnóstico da endometriose do reto e sigmóide 2008
- Nerve fibers in uterosacral ligaments of women with deep infiltrating endometriosis 2008
- Operative und medikamentöse Therapie der Endometriose/Adenomyose 2008
- Caractéristiques IRM de l’endométriose profonde : corrélation aux résultats cœlioscopiques 2008
- Endometrioma of the Large Bowel 2007
- Avaliação da classificação histológica da endometriose observada em implantes de mulheres portadoras de endometriose pélvica superficial e profunda 2007
- Efficacy of vaginal danazol treatment in women with recurrent deeply infiltrating endometriosis 2007
- Endometriosis infiltrativa profunda 2007
- Imagerie de l'endométriose 2006
- Endométriose pelvienne tumorale sous-péritonéale 2006
- Endorectal Ultrasonography in Predicting Rectal Wall Infiltration in Patients With Deep Pelvic Endometriosis: A Modern Tool for an Ancient Disease 2006
- Valeurs diagnostiques de l’échographie et de l’IRM pour l’évaluation de l’endométriose pelvienne profonde 2005
- Deep Pelvic Endometriosis: MR Imaging for Diagnosis and Prediction of Extension of Disease 2004
- Deep Pelvic Endometriosis: MR Imaging for Diagnosis and Prediction of Extension of Disease 2004
- Imagerie de l'endométriose 2004
- Laparoscopic excision of deep endometriosis 2004
- Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis 2004
- Treatment of Endometriosis-Related Pelvic Pain 2003
- Transvaginal sonography and rectal endoscopic sonography for the assessment of pelvic endometriosis: a preliminary comparison 2003
- Rectal endometriosis: high sensitivity and specificity of endorectal ultrasound with an impact for the operative management 2003
- Sonovaginography is a new technique for assessing rectovaginal endometriosis 2003
- Magnetic Resonance Imaging and Endometriosis: Deeply Infiltrating Endometriosis Does Not Originate from the Rectovaginal Septum 2002
- Routine Clinical Examination Is Not Sufficient for Diagnosing and Locating Deeply Infiltrating Endometriosis 2002
- 10.1016/s1241-8218(04)16664-x 2000
- 10.1016/s2211-0666(13)49835-3 2000
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