Clinical characteristics and surgical outcomes of 72 cases of intestinal and urinary tract deep infiltrating endometriosis

The diagnosis and treatment of intestinal and urinary tract deep infiltrating endometriosis (DIE) remain challenging due to its multiple lesions and nonspecific symptoms and signs. This study retrospectively analyzed 72 cases of intestinal and urinary tract DIE, including the clinical characteristics, diagnosis, and treatment outcomes. Among these cases, 11 presented without clinical symptoms, while 61 exhibited obvious clinical symptoms, primarily dysmenorrhea (58.3%, 42 cases) and chronic pelvic pain (50.0%, 36 cases), followed by anal bulge (44.4%, 32 cases), dyspareunia (31.9%, 23 cases), and constipation (16.7%, 12 cases). In terms of diagnosis, combining carbohydrate antigen 125 (CA125) testing with MRI enhanced the detection rate of DIE in the intestine and urinary tract. High-definition laparoscopic surgery was the primary treatment approach in these cases, revealing that intestinal and urinary tract DIE often coexist with ovarian endometriotic cysts, uterosacral ligament involvement, and, less frequently, rectovaginal septum and vaginal lesions. Postoperative follow-ups demonstrated significant symptom relief. In conclusion, intestinal and urinary tract DIE frequently involve multiple sites, and CA125 combined with MRI is an effective diagnostic tool. High-definition laparoscopic surgery offers a definitive treatment for intestinal and urinary tract DIE.