Lesion distribution characteristics of deep infiltrating endometriosis with ovarian endometrioma: an observational clinical study

Hungling Kwok, Hongye Jiang, Tian Li, Huan Yang, Hui Fei, Li Cheng, Cheng Li, Shuzhong Yao, Shuqin Chen
BMC women's health · 2020 · vol. 20(1) · doi:10.1186/s12905-020-00974-y · PMID:32434535 · PMC7240912 · W3026382307
article OA: gold CC0 ⤵ 12 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study found that deep infiltrating endometriosis lesions were more numerous and affected the bowel and vagina more frequently in patients with unilateral ovarian endometrioma compared to those with bilateral endometrioma.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective observational study analyzed data from 304 women who underwent laparoscopic surgery with histologically confirmed ovarian endometrioma (OEM) associated with deep infiltrating endometriosis (DIE), assessing DIE lesion distributions across medical, operative, and pathology records. Across 788 histologically confirmed DIE lesions involving 30 anatomical sites, lesions were frequently multifocal and predominantly located in the posterior pelvic cavity, with the uterosacral ligament as the most common site (80.6%), followed by the intestine and other pelvic structures. Women with unilateral OEM had a significantly higher mean number of DIE lesions than those with bilateral OEM (2.76 ± 1.52 vs. 2.33 ± 1.34), and unilateral OEM showed higher rates of intestinal and vaginal infiltration compared with bilateral OEM, while lesion counts were not significantly correlated with OEM side or size; the paper also frames the cohort as surgically selected. This paper is centrally about endometriosis — specifically characterizing DIE lesion distribution patterns in women with histologically proven ovarian endometrioma.

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Abstract

Abstract Background To investigate the characteristics of deep infiltrating endometriosis (DIE) lesion distribution when associated with ovarian endometrioma (OEM). Methods The present study analyzed retrospective data obtained by the First Affiliated Hospital of Sun Yat-sen University, between June 2008 to June 2016. A total of 304 patients underwent laparoscopic surgery for complete removal of endometriosis by one experienced surgeon, and histological confirmation of OEM associated with DIE was conducted for each patient. Clinical data were recorded for each patient from medical, operative and pathological reports. Patients were then divided into two groups according to unilateral or bilateral OEM. Patients with unilateral OEM were subsequently divided into two subgroups according to OEM location (left- or right-hand side) and the diameter of the OEM (≤50 and > 50 mm). The distribution characteristics of DIE lesions were then compared between the groups. Results DIE lesions were widely distributed, 30 anatomical sites were involved. Patients with associated unilateral OEM ( n = 184 patients) had a significantly increased number of DIE lesions when compared with patients with bilateral OEM ( n = 120 patients; 2.76 ± 1.52 vs. 2.33 ± 1.34; P = 0.006). Compared with bilateral OEM with DIE, there was a higher rate of intestinal (39.1% vs. 18.3%; P < 0.01) and vaginal (17.4% vs. 6.7%; P < 0.01) infiltration by DIE lesions in unilateral OEM with DIE. The mean number of DIE lesions was not significantly correlated with the location or size of the OEM (2.83 ± 1.56 vs. 2.74 ± 1.53; P = 0.678; and 2.65 ± 1.42 vs. 2.80 ± 1.43; P = 0.518, respectively). There was no significant difference between the groups with OEM ≤50 mm and > 50 mm. Conclusion Lesion distribution characteristics in women diagnosed with histologically proven OEM associated with DIE were frequently multifocal and severe.

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Condition tags

endometriosisdie_deep_infiltratingendometrioma

MeSH descriptors

Endometrial Neoplasms Endometriosis Ovarian Neoplasms Adolescent Adult Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometriosis Female Humans Laparoscopy Middle Aged Ovarian Neoplasms Ovarian Neoplasms Retrospective Studies Young Adult

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