Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease.
OBJECTIVE
To describe a computerized pelvic mapping system for pelvic and intestinal endometriosis and preliminary insights gained from it with respect to the effects of ovarian disease.


METHODS
Contemporaneous computerized tabulation of pelvic and intestinal sites of biopsy-proved endometriosis.


METHODS
Tertiary referral center for the surgical treatment of endometriosis.


METHODS
One thousand nine hundred seventy-nine patients with endometriosis, 547 of whom had intestinal endometriosis. Patients with endometriosis with previous hysterectomy (n = 194) with or without castration were excluded from this total, leaving 1,785 patients for this study.


METHODS
Computer tabulation of sites of biopsy-proved pelvic and intestinal endometriosis.


METHODS
Extent of pelvic and intestinal endometriosis as reflected by number of pelvic or intestinal areas involved. Results were stratified by the presence or absence of ovarian endometriosis and by status of previous therapy.


RESULTS
Compared with patients without ovarian endometriosis, patients with ovarian endometriosis have more pelvic and intestinal areas involved by endometriosis. Patients with ovarian endometriosis and intestinal endometriosis are more likely to require full-thickness or segmental bowel resections for complete removal of intestinal disease. These findings persisted when adjusted for previous therapies or presence of superficial versus deep ovarian disease. Only 1.06% of patients had ovarian disease exclusively.


CONCLUSIONS
Superficial or deep ovarian endometriosis is a marker for the presence of more extensive pelvic and intestinal disease. Surgeons diagnosing and treating only ovarian endometriosis may be underdiagnosing and undertreating their patients.
Redwine
D B
DB
St. Charles Medical Center, Bend, Oregon, USA. davidbyron@bendcable.com
D001706:Biopsy; D003628:Database Management Systems; D004715:Endometriosis / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000473:pathology; D016347:Medical Records Systems, Computerized; D010049:Ovarian Diseases / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D018579:Patient Selection; D010388:Pelvis / Q000473:pathology*; D010532:Peritoneal Diseases / Q000150:complications / Q000473:pathology