Cited by 594Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

Deeply infiltrating pelvic endometriosis: histology and clinical significance

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Cornillie, Freddy J., Oosterlynck, Didier, Lauweryns, Joseph M., Koninckx, Philippe R.·1990·Fertility and Sterility

Abstract

In 179 consecutive laparoscopies for infertility (n = 105), pain (n = 60), or both problems (n = 14), endometriosis was diagnosed in 77%, 82%, and 86%, respectively. Eighty implants with positive histology and with careful assessment of depth were sampled by CO2 laser excision from 53 patients. Deep (greater than or equal to 5 mm), intermediate (2 to 4 mm), and superficial (less than 1 mm) infiltration was found in 48%, 35%, and 17% of implants, respectively. Deep infiltration was observed in the pouch of Douglas (55%) and at the uterosacrals (34%), but was absent from the ovarian fossas. Deep implants were found to be active in 68%. At an intermediate depth, however, only 25% of implants were active, whereas 58% of superficial foci showed activity. Deep implants were in phase with the endometrium in 74%. At an intermediate depth, however, only 38% showed regular cyclicity, whereas 57% of superficial implants were in phase with the cycle. Deep infiltration occurred through loose connective tissue septa into the fibromuscular tissue and was always stopped at the underlying fat tissue. Very deep implants (greater than 10 mm) were found exclusively in patients with pain; superficial implants, on the contrary, were found most frequently in patients with infertility (83%).

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Crossref · 10.1016/s0015-0282(16)53570-5

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11 of 11 references verified0 citation errors · 0 not checkable

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  • DE is characterized by the presence of smooth muscle metaplasia (SMM) and a high degree of fibrotic tissues.

    “One feature that DE stands out from other subtypes of endometriosis is its presence of smooth muscle metaplasia (SMM) and its high degree of fibrotic tissues4,15–17”
  • DE lesions typically have higher fibromuscular content than ovarian endometriomas (OE) lesions.

    “DE lesions typically have higher fibromuscular content than that of ovarian endometriomas (OE) lesions, but the underlying reason remains elusive.”
  • Deep endometriosis was described in the early nineties as adenomyosis externa with endometrial glands and stroma in fibromuscular tissue.

    “Deep endometriosis was described in the early nineties as adenomyosis externa (11) with endometrial glands and stroma in fibromuscular tissue.”

    From Pathogenesis of deep endometriosis (2017) · cites this paper as [11]

  • Infiltration by endometrial glands and stroma occurs into adjacent fibromuscular tissue along the loose connective tissue and penetration is arrested at the border of the underlying fat tissue.

    “Cornillie et al. (11) showed that infiltration by endometrial glands and stroma occurs into adjacent fibromuscular tissue along the loose connective tissue and that penetration is arrested at the border of the underlying fat tissue.”

    From Pathogenesis of deep endometriosis (2017) · cites this paper as [11]

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Authors
Cornillie, F. J., Oosterlynck, D., Lauweryns, J. M., & Koninckx, P. R.
Affiliations
KU Leuven (BE)
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
1990-06
Volume
53
Issue
6
Pages
978-983
ISSN
0015-0282 (ISSN-L)
OpenAlex
W78459228
Cited by
594
References
11
Citations by year
2026: 10 · 2025: 19 · 2024: 8 · 2023: 20 · 2022: 16 · 2021: 26 · 2020: 25 · 2019: 22 · 2018: 23 · 2017: 23 · 2016: 18 · 2015: 16 · 2014: 19 · 2013: 17 · 2012: 25
FWCI
11.67
Type
journal article
Language
en
Open access
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
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
pelvic endometriosis, deep infiltrating endometriosis, infertility, dysmenorrhea, CO2 laser excision, pouch of Douglas, endometrioma, histology
MeSH terms
Age Factors, Endometriosis, Endometrium, Female, Humans, Infertility, Pain, Laparoscopy, Uterine Neoplasms

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