Deep endometriosis. Clinical, histopathological and confocal microscopy correlations in intestinal sites.

Abstract

Intestinal endometriosis (IE), a chronic condition affecting a notable percentage of women with endometriosis (estimates varying from roughly 4% to 37%) and can impact any part of the intestine, but it most frequently involves the rectum and sigmoid colon. This is a retrospective study that included 178 women diagnosed with this condition that were investigated taking into consideration the symptoms, diagnostic approaches, surgical treatments, and detailed features of the intestinal wall, including the behavior and quantity of interstitial cells of Cajal (ICC) correlated with the symptomatology experienced. We were able to highlight the most common symptoms such as pelvic pain and bowel disorders. The rectum was identified as the most commonly affected intestinal segment. Transvaginal ultrasound can be valuable in assessing IE, improving preoperative diagnosis and treatment strategies. Laparoscopic surgery remains the definitive diagnostic method, allowing direct visualization and excision of lesions. Surgical technique selections are complex and require careful consideration tailored to each patient. A reduction in ICC numbers may disrupt gut motility, emphasizing their importance in maintaining normal intestinal function, a factor particularly relevant in endometriosis where disruption of ICC networks can contribute to gastrointestinal dysfunction.