Symptom Profiles and Anatomical Distribution of Deep Infiltrating Endometriosis

Area of Science:

• Gynecology
• Gastroenterology
• Surgical Oncology

Background:

• Endometriosis affects women globally, commonly causing pelvic pain and infertility.
• Deep infiltrating endometriosis (DIE) can involve pelvic organs such as the bladder, ureter, and bowel.
• Understanding DIE lesion locations and symptoms is key for effective patient management.

Purpose of the Study:

• To evaluate the symptoms and anatomical locations of endometrial lesions in patients diagnosed with deep infiltrating endometriosis (DIE).
• To enhance the diagnostic and management strategies for DIE by analyzing lesion distribution and associated symptoms.

Main Methods:

• Retrospective analysis of electronic medical records from 22 patients diagnosed with DIE.
• Data collected from a specialized colorectal surgery clinic.
• Frequency distribution and heat maps were used to visualize endometriosis lesion locations.

Main Results:

• The bowel was the most frequent site for endometrial lesions; only 3/22 patients had positive colonoscopies.
• Pelvic peritoneum and ligaments showed the highest lesion burden.
• Abdominal pain was the most common symptom, followed by dyschezia, constipation, and painful menstrual cramps.
• Gastrointestinal symptoms like nausea, diarrhea, and pain with bowel movements were most common in patients with bowel, pelvic peritoneum, and ovarian lesions.

Conclusions:

• The study highlights that common DIE symptoms overlap with gastrointestinal disorders, emphasizing the need to consider DIE in patients presenting with bowel symptoms.
• Further prospective, multicenter research is recommended to validate imaging protocols for DIE.
• Future studies should aim to better differentiate between gynecological and gastrointestinal symptoms associated with DIE.