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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 (27).”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [27]
In the citing paper
“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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Metadata
- 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 › Obstetrics and Gynecology › 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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