Recurrence in deep infiltrating endometriosis: a systematic review of the literature
Abstract
Deep infiltrative endometriosis (DIE) is an enigmatic disease that typically impacts the rectovaginal septum, uterosacral ligaments, pararectal space, and vesicouterine fold but can involve the rectum, sigma, ileum, ureters, diaphragm, and other less common sites. Surgery is the treatment of choice because medical management alone commonly fails in controlling the symptoms although recurrence is very high after surgical treatment. The goal of the current study was to review recurrence rates and identify risk factors related to recurrence after surgery for DIE. The review involved searching the Cochrane Library, PubMed, and Google Scholar for relevant articles in accordance with the study's inclusion criteria; 45 studies were considered suitable. The results showed a wide heterogeneity regarding DIE recurrence because of inconsistent recurrence definitions and follow-up length. Younger age and high body mass index were found to be risk factors for DIE recurrence. Lack of complete surgical excision was another independent risk factor for recurrence of disease. In conclusion, there is a need for prospective studies and a more homogeneous standard for surgical treatment of DIE.
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Recurrence rates of deep endometriosis lesions after complete excision are rare.
“Recurrence rates of deep endometriosis lesions after complete excision are rare (personal observations) (60).”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [60]
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- Authors
- Ianieri, M. M., Mautone, D., & Ceccaroni, M.
- Affiliations
- University of Chieti-Pescara (IT)
- Corresponding author
- Ianieri, Manuel Maria
- Venue
- Journal of Minimally Invasive Gynecology
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 25
- Issue
- 5
- Pages
- 786-793
- ISSN
- 1553-4650 (ISSN-L)
- OpenAlex
- W2790313896
- Cited by
- 76
- References
- 64
- Citations by year
- 2026: 12 · 2025: 5 · 2024: 6 · 2023: 13 · 2022: 10 · 2021: 8 · 2020: 15 · 2019: 3 · 2018: 4
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Minimally Invasive Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- deep infiltrating endometriosis, endometriosis recurrence, recurrence risk factors, body mass index, age, recurrence definition, uterosacral ligament, rectovaginal septum
- MeSH terms
- Endometriosis, Female, Humans, Intestinal Diseases, Peritoneal Diseases, Laparoscopy, Rectum, Recurrence, Risk Factors, Vagina
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