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. 2021 Aug 20;100(33):e26979.
doi: 10.1097/MD.0000000000026979.

Mapping of endometriosis in patients with unilateral endometrioma

Raquel Silveira da Cunha Araujo  1   2 , Sabina Bastos Maia  1 , Juliane Dornelas Lúcio  1 , Moisés Diogo de Lima  1 , Helizabet Salomão Abdalla Ayroza Ribeiro  2 , Paulo Augusto Ayroza Galvão Ribeiro  2
Affiliations

Mapping of endometriosis in patients with unilateral endometrioma

Raquel Silveira da Cunha Araujo et al. Medicine (Baltimore). .

Abstract

To map the distribution of the sites most affected by endometriosis in patients with unilateral ovarian endometriomas.A descriptive case series of 84 patients with unilateral endometriomas undergoing laparoscopy for the treatment of endometriosis. To evaluate the distribution of the sites of endometriosis lesions, the peritoneal compartments were divided into 5 zones: zone 1/the anterior compartment, including the anterior uterine serosa, vesicouterine fold, round ligament, and bladder; zone 2/the lateral compartment, including the left and right ovary, ovarian fossa, tubes, mesosalpinx, uterosacral ligaments, parametrium, and the ureter; zone 3/the posterior compartment, including posterior uterine serosa, the pouch of Douglas, posterior vaginal fornix, and bowel; zone 4 consisting of the abdominal wall; and zone 5 consisting of the diaphragm.Of the 5 zones evaluated, the lateral compartment (zone 2) was the most affected, with 60.7% of the patients having dense adhesions around the left ovarian fossa and 57.1% around the right ovarian fossa. The ovarian endometriomas were more commonly found on the left side (54.8%) compared to the right (45.2%). In the posterior compartment (zone 3), the posterior cul-de-sac was obliterated in 51.2% of the patients. In the anterior compartment (zone 1), there were lesions in the vesicouterine fold in 30.9% of the patients and in the bladder in 19%. Lesions were found in the abdominal wall (zone 4) and diaphragm (zone 5) in 21.4% and 10.7% of patients, respectively.Unilateral endometriomas are important markers of the severity of endometriosis.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Illustration showing the distribution of pelvic zones 1, 2, and 3.
Figure 2
Figure 2
Schematic drawing showing zone 4.
Figure 3
Figure 3
Schematic drawing showing zone 5.
See this image and copyright information in PMC

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