Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain
Open accessAbstract
In a 3-year prospective study of 643 consecutive laparoscopies for infertility, pelvic pain, or infertility and pain, the pelvic area, the depth of infiltration, and the volume of endometriotic lesions were evaluated. The incidence, area, and volume of subtle lesions decreased with age, whereas for typical lesions these parameters and the depth of infiltration increased with age. Deeply infiltrating endometriosis was strongly associated with pelvic pain, women with pain having larger and deeper lesions. Because deep endometriosis has little emphasis in the revised American Fertility Society classification and after analyzing the diagnoses made in each class, considerations for a simplifying revision with inclusion of deep lesions are suggested. In conclusion, suggestive evidence is presented to support the concept that endometriosis is a progressive disorder, and it is demonstrated that deep endometriosis is strongly associated with pelvic pain.
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Cystic ovarian endometriosis causes pain in more than 80%, and deep endometriosis causes severe pain in the large majority of women.
“Cystic ovarian endometriosis causes pain in more than 80%, and deep endometriosis causes severe pain in the large majority of women (27).”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [27]
Deep endometriosis is a specific disease, reflected in the distribution of deep lesions in all classes of The Revised American Fertility Society (AFS) classification with little association with cystic ovarian endometriosis.
“The interpretation that deep endometriosis is a specific disease is reflected in the distribution of deep lesions in all classes of The Revised American Fertility Society (AFS) classification with little association with cystic ovarian endometriosis (Fig. 4).”
From Pathogenesis of deep endometriosis (2017) · cites this paper as [234]
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Guerriero, S., AJOSSA, S., Gerada, M., Virgilio, B. A., Angioni, S. L., & Melis, G. B. (2008) · Human Reproduction · doi:10.1093/humrep/den293 · Cited by 163 · see citing works
Peritoneal Cellular Immunity and Endometriosis
Ho, H., Wu, M., & Yang, Y. (1997) · American Journal of Reproductive Immunology · doi:10.1111/j.1600-0897.1997.tb00319.x · Cited by 160 · see citing works
Thomassin‐Naggara, I., Bazot, M., Detchev, R., Barranger, E., Cortez, A., & Daraï, É. (2004) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2003.12.004 · Cited by 156 · see citing works
Chapron, C., Vieira, M., Chopin, N., Balleyguier, C., Barakat, H., Dumontier, I., Roseau, G., Fauconnier, A., Foulot, H., & Dousset, B. E. (2004) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.1107 · Cited by 156 · see citing works
Chopin, N., Vieira, M., Borghese, B., Foulot, H., Dousset, B., Coste, J., Mignon, A., Fauconnier, A., & Chapron, C. (2005) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2005.01.015 · Cited by 154 · see citing works
Dmowski, W. P., Lesniewicz, R., Rana, N., Pepping, P., & Noursalehi, M. (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)81904-8 · Cited by 151 · see citing works
Chapron, C., Dubuisson, J.-B., Pansini, V., Vieira, M., Fauconnier, A., Barakat, H., & Dousset, B. E. (2002) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)60117-x · Cited by 150 · see citing works
Results and role of rectal endoscopic ultrasonography for patients with deep pelvic endometriosis
Chapron, C., Dumontier, I., Dousset, B. E., Fritel, X., Tardif, D., Roseau, G., Chaussade, S., Couturier, D., & Dubuisson, J. B. (1998) · Human Reproduction · doi:10.1093/humrep/13.8.2266 · Cited by 150 · see citing works
Ovarian endometrioma: severe pelvic pain is associated with deeply infiltrating endometriosis
Chapron, C., Santulli, P., de Ziegler, D., Noël, J. C., Anaf, V., Streuli, I., Foulot, H., de Souza, C. A. B., & Borghese, B. (2012) · Human Reproduction · doi:10.1093/humrep/der462 · Cited by 146 · see citing works
Sonovaginography is a new technique for assessing rectovaginal endometriosis
Dessole, S., Farina, M., Rubattu, G., Cosmi, E., Ambrosini, G., & Nardelli, G. B. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(02)04952-x · Cited by 144 · see citing works
Laparoscopic segmental colorectal resection for endometriosis: limits and complications
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Environmental PCB exposure and risk of endometriosis
Louis, G. M. B., Weiner, J. M., Whitcomb, B. W., Sperrazza, R., Schisterman, E. F., Lobdell, D. T., Crickard, K., Greizerstein, H. B., & Kostyniak, P. J. (2004) · Human Reproduction · doi:10.1093/humrep/deh575 · Cited by 139 · see citing works
Chronic pelvic pain in women: etiology, pathogenesis and diagnostic approach
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Clinical relevance of the baboon as a model for the study of endometriosis
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Possible involvement of hMLH1, p16INK4a and PTEN in the malignant transformation of endometriosis
Martini, M., Ciccarone, M., Garganese, G., Maggiore, C., Evangelista, A., Rahimi, S., Zannoni, G. F., Vittori, G., & Larocca, L. M. (2002) · International Journal of Cancer · doi:10.1002/ijc.10715 · Cited by 134 · see citing works
- Authors
- Koninckx, P. R., Meuleman, C., Demeyere, S., Lesaffre, E., & Cornillie, F. J.
- Affiliations
- KU Leuven (BE)
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1991-04
- Volume
- 55
- Issue
- 4
- Pages
- 759-765
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2291960606
- Cited by
- 849
- References
- 17
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 12 · 2023: 15 · 2022: 21 · 2021: 26 · 2020: 32 · 2019: 24 · 2018: 34 · 2017: 29 · 2016: 33 · 2015: 25 · 2014: 29 · 2013: 35 · 2012: 35
- FWCI
- 14.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- 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, disease progression, pelvic pain, lesion volume, age-related changes, infertility, diagnostic laparoscopy
- MeSH terms
- Aging, Dyspareunia, Endometriosis, Female, Humans, Menstruation Disturbances, Neoplasm Invasiveness, Pain, Pelvis, Prospective Studies
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