Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Apr;15(2):88-94.
doi: 10.22074/IJFS.2020.134689. Epub 2021 Mar 11.

Management Challenges of Deep Infiltrating Endometriosis

Maurizio Nicola D'Alterio  1 , Gianmarco D'Ancona  1 , Mohamed Raslan  2 , Raffaele Tinelli  3 , Angelos Daniilidis  4 , Stefano Angioni  5
Affiliations
Review

Management Challenges of Deep Infiltrating Endometriosis

Maurizio Nicola D'Alterio et al. Int J Fertil Steril. 2021 Apr.

Abstract

Deep infiltrating endometriosis (DIE) is the most aggressive of the three phenotypes that constitute endometriosis. It can affect the whole pelvis, subverting the anatomy and functionality of vital organs, with an important negative impact on the patient's quality of life. The diagnosis of DIE is based on clinical and physical examination, instrumental examination, and, if surgery is needed, the identification and biopsy of lesions. The choice of the best therapeutic approach for women with DIE is often challenging. Therapeutic options include medical and surgical treatment, and the decision should be dictated by the patient's medical history, disease stage, symptom severity, and personal choice. Medical therapy can control the symptoms and stop the development of pathology, keeping in mind the side effects derived from a long-term treatment and the risk of recurrence once suspended. Surgical treatment should be proposed only when it is strictly necessary (failed hormone therapy, contraindications to hormone treatment, severity of symptoms, infertility), preferring, whenever possible, a conservative approach performed by a multidisciplinary team. All therapeutic possibilities have to be explained by the physicians in order to help the patients to make the right choice and minimize the impact of the disease on their lives.

Keywords: Endometriosis; Surgery; Therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig.1
Fig.1
Laparoscopic view of posterior compartment deep infiltrating en- dometriosis (DIE).
See this image and copyright information in PMC

References

    1. Angioni S. New insights on endometriosis. Minerva Ginecol. 2017;69(5):438–439. - PubMed
    1. Eisenberg VH, Weil C, Chodick G, Shalev V. Epidemiology of endometriosis: a large population-based database study from a healthcare provider with 2 million members. BJOG. 2018;125(1):55–62. - PubMed
    1. Alio L, Angioni S, Arena S, Bartiromo L, Bergamini V, Berlanda N, et al. Endometriosis: seeking optimal management in women approaching menopause. Climacteric. 2019;22(4):329–338. - PubMed
    1. Vitale SG, La Rosa VL, Rapisarda AMC, Laganà AS. Impact of endometriosis on quality of life and psychological well-being. J Psychosom Obstet Gynaecol. 2017;38(4):317–319. - PubMed
    1. Šalamun V, Verdenik I, Laganà AS, Vrtačnik-Bokal E. Should we consider integrated approach for endometriosis-associated infertility as gold standard management?. Rationale and results from a large cohort analysis. Arch Gynecol Obstet. 2018;297(3):613–621. - PubMed

LinkOut - more resources