Deep Pelvic Endometriosis
Deep pelvic endometriosis is a form of endometriosis in which tissue similar to the uterine lining grows outside the uterus and infiltrates deeper into pelvic structures. These lesions can involve the ovaries, pelvic ligaments, bowel, bladder, or other tissues. Deep endometriosis often causes significant pain, especially during menstruation, intercourse, or bowel movements, and may contribute to infertility.
What is it?
Deep pelvic endometriosis occurs when endometrial-like tissue penetrates deeper than 5 mm beneath the surface of the pelvic peritoneum. This deeper infiltration can affect major pelvic structures such as the ovaries, rectum, sigmoid colon, uterosacral ligaments, and bladder. The inflammation and scarring from these lesions can lead to pain, adhesions, and impaired organ movement.
MRI is highly effective in identifying deep endometriotic implants, areas of fibrosis, ovarian endometriomas, and involvement of surrounding organs. Ultrasound can detect some lesions, particularly ovarian endometriomas, but MRI provides a more comprehensive view of deep pelvic involvement.
Important to Know
Deep pelvic endometriosis may cause severe symptoms and can significantly impact daily life. Early diagnosis can help guide treatment and improve quality of life. Hormonal therapies may reduce symptoms, but deeply infiltrating lesions often require specialized surgical management for lasting relief.
Red flag symptoms include severe pelvic pain that does not improve with medication, difficulty urinating or defecating, rectal bleeding during menstruation, or persistent infertility. These may indicate advanced disease requiring prompt evaluation by a specialist. Follow-up imaging can help track progression or response to treatment.