Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis
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Charles Chapron1, Claire Pietin-Vialle, Bruno Borghese
1Université Paris Descartes V, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Universitaire Ouest, CHU Cochin, Service de Gynécologie Obstétrique II et Médecine de la Reproduction, Paris, France. charles.chapron@cch.aphp.fr
Objective:
To investigate whether an associated ovarian endometrioma is a marker for severity of deep infiltrating endometriosis (DIE).
Design:
Observational study between June 1992 and December 2005.
Setting:
University tertiary referral center.
Patient(S):
Five hundred patients with histologically assessed DIE.
Intervention(S):
Complete surgical exeresis of deep endometriotic lesions.
Main Outcome Measure(S):
Severity of the disease was quantified according to the mean number of DIE lesions and the type of main lesion.
Result(S):
In patients with associated ovarian endometrioma, the number of single isolated DIE lesions was statistically significantly lower (41.9% vs. 61.1%). The mean number of DIE lesions was statistically significantly higher in patients presenting with an associated ovarian endometrioma (2.51 +/- 1.72 vs. 1.64 +/- 1.0). For patients with associated ovarian endometrioma DIE lesions were more severe with an increased rate of vaginal, intestinal, and ureteral lesions.
Conclusion(S):
Associated ovarian endometrioma is a marker for the severity of the DIE. In a clinical context suggestive of DIE, when there is an ovarian endometrioma, the practitioner should investigate the extent of the disease to check for severe and multifocal DIE lesions.
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