Radical excision of the uterosacral ligament complex

In: Modern Management of Endometriosis · 2005 · pp. 236–243 · doi:10.1201/b14621-27 · W4233541831
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This study defines deep infiltrating endometriosis (DIE) histologically as lesions penetrating at least 5 mm and notes that retrocervical location, not necessarily the rectovaginal septum, is a frequent origin for DIE.

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Abstract

Three types of endometriosis have been described: superficial endometriosis, ovarian endometriomas, and deeply infiltrating endometriosis (DIE). The definition used for DIE in the international literature is histologic. DIE is defined as an endometriotic lesion penetrating to a depth of at least 5 mm.1 The main symptom where DIE is involved is pelvic pain, the intensity of which is significantly correlated with the depth to which the lesions penetrate.1-3It is essential to know exactly where deep endometriosis lesions are located because the efficacy of surgical treatment depends on how radical the surgical excision has to be.4 Magnetic resonance imaging (MRI) results help to pinpoint the location of DIE lesions better. DIE lesions are initially located retrocervically above the upper border of the rectovaginal septum.5 A retrocervical location is very frequent for DIE lesions and involvement of the rectovaginal septum is not systematic.6 DIE originates from the retrocervical area and the rectovaginal septum does not appear to be the initial location for DIE lesions.7

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endometriosisdie_deep_infiltrating

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