Using location, color, size, and depth to characterize and identify endometriosis lesions in a cohort of 133 women
Open accessAbstract
Objective To correlate histology with endometriosis characteristics. Design Secondary data analysis. Setting Government research hospital. Patient(s) One hundred thirty-three women with chronic pelvic pain and endometriosis who underwent laparoscopic surgery between 1999 and 2004. Intervention(s) Laparoscopic excision of lesions, including recording of lesion characteristics and surgical impression of the lesions. Main outcome measure(s) All biopsies were sent for histological examination for endometriosis, and surgical and histological findings were compared. Result(s) Three hundred fifty-seven of 544 lesions believed to be endometriosis by the surgeon had positive histology. Mixed-color lesions most commonly contained endometriosis (76%), with the percentage of positive lesions being similar between single-color groups. Among subtle (red or white) lesions, 58% (164/283) were positive for endometriosis. Thirty women had only red or white lesions, and 18 (60%) had at least one lesion positive for endometriosis. Lesions were most commonly located in the cul-de-sac (64%), utero-sacral ligaments (68%), and ovarian fossa (70%). Conclusion(s) Wide, deep, mixed-color lesions in the cul-de-sac, the ovarian fossa, or the utero-sacral ligaments had the highest frequency of endometriosis. More than half of subtle lesions had endometriosis. These results should be considered when diagnosing endometriosis.
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Biopsy-proven endometriosis occurs at similar frequency across single-color lesions and most often in mixed-color lesions.
“the frequency of biopsy-proven endometriosis is similar among all single-colored lesions and highest in mixed-color lesions”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Stegmann et al., 2008b
The same HPA dysfunction likely applies to endometriosis and chronic pain.
“The same situation likely applies to endometriosis and chronic pain (Stegmann et al., 2008a).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Stegmann et al., 2008a
The Methods and Discussion describe women with chronic pelvic pain and endometriosis, but do not address HPA-axis dysfunction. Searches for HPA, hypothalamic–pituitary–adrenal, cortisol, and stress returned no passage supporting the proposed connection. (LLM, conf=0.76)
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Cites
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Cited by
Sorted by citations
Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications
Stratton, P., & Berkley, K. J. (2011) · Human Reproduction Update · doi:10.1093/humupd/dmq050 · Cited by 442 · see citing works
Self-citationRogers, P. A. W., D’Hooghe, T. M., Fazleabas, A., Giudice, L. C., Montgomery, G. W., Petraglia, F., & Taylor, R. N. (2013) · Reproductive Sciences · doi:10.1177/1933719113477495 · Cited by 154 · see citing works
Vincent, K., Kennedy, S., & Stratton, P. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.09.056 · Cited by 132 · see citing works
Self-citationProteomic identification of neurotrophins in the eutopic endometrium of women with endometriosis
Browne, A. S., Yu, J., Huang, R.-P., Francisco, A. M. C., Sidell, N., & Taylor, R. N. (2012) · Fertility and Sterility · doi:10.1016/j.fertnstert.2012.05.027 · Cited by 78 · see citing works
Adiposity and endometriosis severity and typology
Byun, J., Peterson, C. M., Backonja, U., Taylor, R. N., Stanford, J. B., Allen-Brady, K. L., Smith, K. R., Louis, G. M. B., & Schliep, K. C. (2020) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2020.01.002 · Cited by 27 · see citing works
“However, similar to our findings, prior studies have also found high correlation between visual lesions and pathological confirmation [37,38].”
ResultMifepristone 2.5, 5, 10mg versus placebo in the treatment of endometriosis
Carbonell, J. L., Riverón, A. M., Leonard, Y., González, J., Heredia, B., & Sánchez, C. (2016) · Journal of Reproductive Health and Medicine · doi:10.1016/j.jrhm.2015.09.001 · Cited by 25 · see citing works
Nezhat, C. R., Oskotsky, T. T., Robinson, J. F., Fisher, S. J., Tsuei, A., Liu, B., Irwin, J. C., Gaudilliere, B., Sirota, M., Stevenson, D. K., et al. (2025) · npj Women s Health · doi:10.1038/s44294-024-00052-w · Cited by 25 · see citing works
- Authors
- Stegmann, B. J., Sinaii, N., Liu, S., Segars, J., Merino, M., Nieman, L. K., & Stratton, P.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Stratton, Pamela
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2008-06
- Volume
- 89
- Issue
- 6
- Pages
- 1632-1636
- ISSN
- 0015-0282 (ISSN-L)
- PMC
- PMC2505050
- OpenAlex
- W2046381495
- Cited by
- 81
- References
- 1
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 7 · 2015: 4 · 2014: 3 · 2013: 5 · 2012: 8
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Child Health and Human Development
- NIH Clinical Center
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (Z01HD008728)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometriosis, lesion color, lesion localization, lesion depth, lesion size, histopathological confirmation, laparoscopic resection, chronic pelvic pain, cul-de-sac
- MeSH terms
- Adolescent, Adult, Urinary Bladder, Endometriosis, Estrogen Antagonists, Female, Humans, Middle Aged, Ovary, Laparoscopy, Uterus, Cohort Studies, Raloxifene Hydrochloride
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