Derin İnfiltratif Endometriozisin Tanımı ve Başlıca Semptomları
Synopsis
Derin İnfiltratif Endometriozis (DIE), endometriozisin en agresif formudur ve pelvik organların anatomisini etkileyerek hastanın yaşam kalitesini olumsuz yönde etkiler. Hastalık, ektopik endometriyal dokunun inflamatuar yanıtı ve pelvik organlardaki deformasyon ile karakterizedir. Tanımında, 5 mm'den derin endometriotik lezyonlar dikkate alınır ve genellikle büyük boyutlu ve infiltratif nitelikte olurlar. Semptomlar arasında dismenore, disparoni, dizüri, hematüri, diskazi, kabızlık, bağırsak krampları ve abdominal ağrı yer alır. Semptomların şiddeti hastalığın evresine bağlı olarak değişir ve doğru tanı koymak ile uygun tedavi sürecini belirlemek için önemlidir.
Deep Infiltrating Endometriosis (DIE) is considered the most aggressive form of endometriosis, negatively impacting the patient's quality of life by affecting the anatomy of pelvic organs. The condition is characterized by an inflammatory response to ectopic endometrial tissue and subsequent deformation of pelvic organs. It is defined by the presence of endometriotic lesions deeper than 5 mm, which are typically large and infiltrative in nature. Symptoms include dysmenorrhea, dyspareunia, dysuria, hematuria, dyschezia, constipation, intestinal cramps, and abdominal pain. The severity of symptoms varies depending on the stage of the disease, making accurate diagnosis and appropriate treatment essential.
References
Gordts S, Koninckx P, Brosens I. Pathogenesis of deep endometriosis. Fertil Steril. 2017;108:872-885.e1.
Kele H. Ultrasound of the nerves. In: Csiba L, Baracchini C, eds. Manual of Neurosonology. 1st ed. Cambridge University Press; 2016:306-312
D'Alterio MN, D'Ancona G, Raslan M, Tinelli R, Daniilidis A, Angioni S. Management Challenges of Deep Infiltrating Endometriosis. Int J Fertil Steril. 2021 Apr;15(2):88-94. doi: 10.22074/IJFS.2020.134689. Epub 2021 Mar 11. PMID: 33687160; PMCID: PMC8052801.
Koninckx PR, Ussia A, Adamyan LV, Wattiez A, Donnez J. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012; 98(3): 564-571.
Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016: 2(2): CD009591.
Chapron C, Chiodo I, Leconte M, Amsellem-Ouazana D, Chopin N, Borghese B, et al. Severe ureteral endometriosis: the intrinsic type is not so rare after complete surgical exeresis of deep endometriotic lesions. Fertil Steril. 2010; 93(7): 2115-2120.
Conservative laparoscopic management of urinary tract endometriosis (UTE): surgical outcome and long-term follow-up. Seracchioli R, Mabrouk M, Montanari G, Manuzzi L, Concetti S, Venturoli S Fertil Steril. 2010 Aug;94(3):856-61. Epub 2009 May 29.
Definition of ureteral endometriosis? Donnez J, Brosens I Fertil Steril. 1997 Jul;68(1):178-80.
Butticè S, Laganà AS, Mucciardi G, Marson F, Tefik T, Netsch C, et al. Different patterns of pelvic ureteral endometriosis. What is the best treatment? Results of a retrospective analysis. Arch Ital Urol Androl. 2016; 88(4): 266-269.
Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ Fertil Steril. 1991;55(4):759.
Bowel endometriosis: presentation, diagnosis, and treatment. Remorgida V, Ferrero S, Fulcheri E, Ragni N, Martin DC Obstet Gynecol Surv. 2007;62(7):461.
Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease. Redwine DB Fertil Steril. 1999;72(2):310.
Ureteral and vesical endometriosis. Two different clinical entities sharing the same pathogenesis. Berlanda N, Vercellini P, Carmignani L, Aimi G, Amicarelli F, Fedele L Obstet Gynecol Surv.2009;64(12):830.
Can specific pain symptoms help in the diagnosis of endometriosis? A cohort study of women with chronic pelvic pain. Ballard K, Lane H, Hudelist G, Banerjee S, Wright J Fertil Steril. 2010;94(1):20. Epub 2009 Apr 1.
Vulval Endometriosis Following Vaginal Hysterectomy. Sharp C, Kulkarni M, Rosamilia A, Tsaltas J , J Minim Invasive Gynecol. 2020;27(7):1453. Epub 2020 Feb 25.
Clinical features of thoracic endometriosis: A single center analysis. Hwang SM, Lee CW, Lee BS, Park JH Obstet Gynecol Sci. 2015 May;58(3):223-31. Epub 2015 May 19.
