Deep Infiltrating Endometriosis (DIE): Patient characteristics, medical history and indications for surgical treatment in a large single centre patient cohort

Matthias Grube, Miklós Góth, Teresa Praetorius, Jürgen Andress, J Grimm, Sabine Hoffmann, Felix Neis, Christos Tsaousidis, SY Brucker, Bernhard Krämer, Stefan Kommoss
In: Geburtshilfe und Frauenheilkunde · 2018 · doi:10.1055/s-0038-1671097 · W2898849248
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-11 ⓘ

This study identified patient characteristics and indications for surgical treatment in a large cohort of women with deep infiltrating endometriosis, a challenging form associated with pain and infertility.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This retrospective single-center study reviewed charts of 524 women with deep infiltrating endometriosis (DIE) treated between 2005 and 2015, describing patient characteristics, medical history, and indications for surgical treatment. Patients had a mean age of 33.4 years and BMI of 23.2 kg/m2; 54.5% had comorbidities and 65% had prior surgery, with 51.5% having previously been surgically treated for endometriosis. Most surgeries (80.3%) were performed for pelvic pain, while infertility accounted for 12.7% and asymptomatic ureteral involvement for 7%; the authors also note that in 36% of patients endometriosis was already histologically proven, prompting DIE surgery as a second laparoscopy. A stated limitation is its retrospective chart-review design from a single institution. This paper is centrally about endometriosis — it focuses on patient characteristics and surgical indications for deep infiltrating endometriosis.

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Abstract

DIE is the most challenging type of endometriosis and may be associated with severe pain and infertility. Complete minimally invasive resection is the gold standard treatment, leading to pain relief and increased fertility in a high number of women. This study aims to identify specific patient characteristics and indications for DIE surgery in a large single endometriosis centre.
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Objectives

DIE is the most challenging type of endometriosis and may be associated with severe pain and infertility. Complete minimally invasive resection is the gold standard treatment, leading to pain relief and increased fertility in a high number of women. This study aims to identify specific patient characteristics and indications for DIE surgery in a large single endometriosis centre.

Methods

Retrospective chart review of DIE patients treated between 2005 – 2015.

Results

524 patients were analysed. Average age was 33,42yrs at surgery. Mean BMI was 23,21 kg/m2. Co-morbidities were found in 54,5% of patients, with hypothyroidism, depression and migraine being the most frequent diagnoses. 65% of patients had previous surgery in their medical history, with 51,5% being surgically treated for endometriosis before. The majority of patients (80,3%) was treated in the context of pelvic pain, whereas infertility and asymptomatic ureteral involvement led to DIE surgery in 12,7% and 7% respectively. In 36% of patients endometriosis was already proven histologically, thus DIE surgery was planned as a second laparoscopy.

Conclusion

Patients surgically treated for DIE at our institution were found to be in their 30 s, in many cases final DIE surgery was performed after a preceding history of other endometriosis treatments. In 4 of 5 patients surgery was performed to achieve pelvic pain relief. Based on our findings presented herein we will be able to provide specific peer group education and patient counselling. Clinical follow-up studies will allow us to investigate recurrence rates and the impact of DIE surgery on pregnancy conception.

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endometriosisdie_deep_infiltratinginfertility

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