Deep endometriosis: clinical and epidemiological findings of diagnosed women according to the criteria of the international deep endometriosis analysis group (IDEA)

Abstract

Introduction: endometriosis occurs when tissue similar to the endometrium affects the peritoneum, which can infiltrate structures and organs such as the bowel, ureter, bladder or vagina and is usually accompanied by an inflammatory process. It is estimated that the disease affects 6 to 10% of women of reproductive age and more than 50% of infertile women. The clinical and epidemiological data of patients with DE come from studies whose women were selected by surgery, therefore subject to selection bias. Transvaginal pelvic ultrasound with bowel preparation (TVUBP) has high specificity and sensitivity values. Objective: analyze the clinical and epidemiological profile of patients with DE diagnosed through the TVUBP. Methods: a cross-sectional study that analyzed 227 patients with an ultrasound diagnosis of deep endometriosis. Results: infertility affected 43.8% of women. Painful symptoms considered as moderate or severe (visual analogue scale, VAS, >3) had the following prevalence and mean values on the VAS scale, respectively: dysmenorrhea in 84.7% (6.9), dyspareunia in 69.1%, (4.2) menstrual dyschezia in 60.7% (4.3) and menstrual dysuria in 35.7% of patients. A history of multiple surgeries occurred in 10.4% and only 6.8% of patients had undergone physiotherapy for the pelvic floor. Conclusion: the DE population had a high prevalence of infertility and pain symptoms, findings that reflect the social impact on the quality of life and family planning of these women. The high frequency of history of multiple surgical approaches and the low incidence of history of pelvic physiotherapy in the population with DE, contrary to the currently established ideal treatment recommendations, indicate the difficulty of access for patients to specialized centers.