Objectives:
DIE is the most challenging type of endometriosis and may be associated with severe
pain and infertility. Complete minimally invasive resection is the gold standard treatment,
leading to pain relief and increased fertility in a high number of women. This study
aims to identify specific patient characteristics and indications for DIE surgery
in a large single endometriosis centre.
Methods:
Retrospective chart review of DIE patients treated between 2005 – 2015.
Results:
524 patients were analysed. Average age was 33,42yrs at surgery. Mean BMI was 23,21
kg/m2. Co-morbidities were found in 54,5% of patients, with hypothyroidism, depression
and migraine being the most frequent diagnoses. 65% of patients had previous surgery
in their medical history, with 51,5% being surgically treated for endometriosis before.
The majority of patients (80,3%) was treated in the context of pelvic pain, whereas
infertility and asymptomatic ureteral involvement led to DIE surgery in 12,7% and
7% respectively. In 36% of patients endometriosis was already proven histologically,
thus DIE surgery was planned as a second laparoscopy.
Conclusion:
Patients surgically treated for DIE at our institution were found to be in their 30
s, in many cases final DIE surgery was performed after a preceding history of other
endometriosis treatments. In 4 of 5 patients surgery was performed to achieve pelvic
pain relief. Based on our findings presented herein we will be able to provide specific
peer group education and patient counselling. Clinical follow-up studies will allow
us to investigate recurrence rates and the impact of DIE surgery on pregnancy conception.
