Deep Infiltrating Endometriosis (DIE): Patient characteristics, medical history and indications for surgical treatment in a large single centre patient cohort

Objectives:

DIE is the most challenging type of endometriosis and may be associated with severe pain and infertility. Complete minimally invasive resection is the gold standard treatment, leading to pain relief and increased fertility in a high number of women. This study aims to identify specific patient characteristics and indications for DIE surgery in a large single endometriosis centre.

Methods:

Retrospective chart review of DIE patients treated between 2005 – 2015.

Results:

524 patients were analysed. Average age was 33,42yrs at surgery. Mean BMI was 23,21 kg/m². Co-morbidities were found in 54,5% of patients, with hypothyroidism, depression and migraine being the most frequent diagnoses. 65% of patients had previous surgery in their medical history, with 51,5% being surgically treated for endometriosis before. The majority of patients (80,3%) was treated in the context of pelvic pain, whereas infertility and asymptomatic ureteral involvement led to DIE surgery in 12,7% and 7% respectively. In 36% of patients endometriosis was already proven histologically, thus DIE surgery was planned as a second laparoscopy.

Conclusion:

Patients surgically treated for DIE at our institution were found to be in their 30 s, in many cases final DIE surgery was performed after a preceding history of other endometriosis treatments. In 4 of 5 patients surgery was performed to achieve pelvic pain relief. Based on our findings presented herein we will be able to provide specific peer group education and patient counselling. Clinical follow-up studies will allow us to investigate recurrence rates and the impact of DIE surgery on pregnancy conception.