Histologic Appearance of Endometriosis Infiltrating Uterosacral Ligaments in Women with Painful Symptoms
Abstract
Study objective To describe the histologic appearance of deep endometriosis infiltrating the uterosacral ligaments (USL).Design Retrospective analysis (Canadian Task Force classification II-2).Setting University-affiliated hospital.Patients One hundred forty-nine women with pain due to endometriosis.Intervention Resection of one or both USL.Measurements and main results One hundred seventy-two USL were examined by histology after unilateral resection in 126 patients (84.6%) and bilateral resection in 23 (15.4%). Two-thirds of women (122, 70.9%) had a classic appearance of endometriosis. Lesions of myoproliferative endometriosis with a histologic appearance of so-called adenomyotic nodules were observed in 25 (14.5%). Associated fibrosis was most frequent in patients with positive compared with negative histology (85, 69.7% vs 18, 36.0%).Conclusion Anatomicopathologic lesions of deep endometriosis infiltrating the USL are heterogeneous. Adenomyotic nodules are not frequently observed.
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The findings explain why DE lesions have abundant SMC-like cells and more extensive fibrosis than OE lesions.
“This also provides an answer to a long-standing conundrum as why DE lesions have abundant SMC-like cells17,25,46 and more extensive fibrosis than that of OE lesions2,4,24,28,46.”
From Neuropeptides Substance P and Calcitonin Gene Related Peptide Accelerate the Development and Fibrogenesis of Endometriosis (2019) · cites this paper as [46]
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- Authors
- Bonte, H., Chapron, C., Vieira, M., Fauconnier, A., Barakat, H., Fritel, X., Vacher-Lavenu, M.-C., & Dubuisson, J.-B.
- Affiliations
- Hôpital Cochin (FR)
- Hôpital Rothschild (FR)
- Corresponding author
- Chapron, Charles
- Venue
- The Journal of the American Association of Gynecologic Laparoscopists
- Publisher
- Elsevier BV
- Published
- 2002-11
- Volume
- 9
- Issue
- 4
- Pages
- 519-524
- ISSN
- 1074-3804 (ISSN-L)
- OpenAlex
- W2089234296
- Cited by
- 61
- References
- 26
- Citations by year
- 2024: 2 · 2023: 1 · 2021: 4 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 1 · 2012: 6
- FWCI
- 2.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of the American Association of Gynecologic Laparoscopists (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
- deep infiltrating endometriosis, uterosacral ligament, fibrosis, pelvic pain, histological heterogeneity
- MeSH terms
- Biopsy, Needle, Broad Ligament, Endometriosis, Female, Humans, Immunohistochemistry, Laparoscopy, Retrospective Studies, Sensitivity and Specificity, Severity of Illness Index, Cohort Studies, Pelvic Pain, Culture Techniques
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