Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification

Abstract

Multifocality must be considered during the pre-operative work-up and surgical treatment of DIE. We propose a surgical classification based on the locations of DIE. Operative laparoscopy is efficient for bladder, USL and vaginal DIE. However, indications for laparotomy still exist, notably for bowel lesions.

Imaging for the evaluation of endometriosis and adenomyosis

“…If intestinal infiltration is found at transvaginal sonography, we feel that MRI or DBCE is not always needed, given that it will provide no further information when lesions are small. If there is a strong clinical suspicion of intestinal involvement, however, but transvaginal sonography shows no intestinal infiltration, MRI could be useful to exclude lesions of the upper intestinal tract [48,49,51].…”

“…Transvaginal sonographic examination is based on a detailed evaluation of organ and tissues dividing the pelvis in the anterior and posterior compartment according to the DIE classification by Chapron et al [51]. …”

“…Although reported sensitivity and specificity of transvaginal sonography in the prediction of DIE is high [47][48][49][50][51][52][53][54][55][56][57][58], evaluation of DIE by transvaginal sonography is difficult and requires expertise. Therefore, some easily detectable utrasonographic signs have recently been proposed to predict the risk of the presence of DIE.…”

Endometriose do trato gastrintestinal: correlações clínicas e laparoscópicas

“…Correlacionando o estadiamento da doença 7 e a presença de endometriose em segmentos do TGI durante o procedimento da COPE, observou-se que houve correlação mais definida nos dois extremos. Jerby 12 (1999) observou lesão colorretal em 28 das 30 pacientes que pertenciam ao estádio IV. Redwine 16 (1999) afirmou que lesões nos ovários eram um sinalizador de lesões no TGI.…”

Three‐dimensional sonorectography: a new transvaginal ultrasound technique with intrarectal contrast to assess colorectal endometriosis

“…Although there are symptoms associated with DIE 1 , they are not specific for severity or location of DIE lesions 2 . Some studies have shown that the performance of transvaginal sonography (TVS) could be similar, if not superior, to that of magnetic resonance imaging (MRI), which is the reference technique for diagnosing endometriosis 3 -5 .…”