True Prevalence of Diaphragmatic Endometriosis and Its Association with Severe Endometriosis: A Call for Awareness and Investigation

Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes

“…A strong association between thoracic endometriosis and infertility was previously reported in the literature [37]. Although the same correlation has not been established yet in diaphragmatic endometriosis, patients with diaphragmatic endometriosis were reported to have higher rates of infertility compared with endometriosis patients without diaphragmatic involvement [14]. The infertility rate in our cohort is 52.4%, which is slightly higher than what is reported in the literature.…”

“…Similarly, Ceccaroni et al reported in their two studies that the majority of diaphragmatic endometriosis patients had stage IV pelvic endometriosis [29,36]. This association was also emphasized by a recent study demonstrating that most diaphragmatic endometriosis patients (78.4%) have stage III-IV endometriosis [14]. Interestingly, diaphragmatic endometriosis was suggested to be an indirect sign of severe pelvic disease [36].…”

“…Diaphragmatic endometriosis was first described by Brews in 1954 [12]. Its estimated prevalence ranges between 0.67% and 4.7% [13,14].…”

2023 Update on minimally invasive gynecologic surgery

“…P agano and colleagues conducted an impressive large prospective cohort study that included more than 1,300 patients with histologically proven endometriosis. 1 Each patient underwent a systematic evaluation and reporting of intraoperative findings, including bilateral evaluation for diaphragmatic endometriosis (DE).…”

“…Endometriosis and adenomyosis were at the center of several large cohort studies and systematic reviews that reassessed what we know about how to evaluate and treat these challenging diseases, including both surgical and nonsurgical approaches, with an emphasis on fertility-sparing modalities. [1][2][3][4][5][6][7][8] In addition, a focus on quality of life, patientcentered care, and racial biases allowed us to reflect on our own practice patterns and keep the patient at the center of care models. [9][10][11][12][13] Finally, there was a clear expansion in the use of technologies such as artificial intelligence (AI) and machine learning for care and novel minimally invasive tools.…”