Association rate between deep peritoneal endometriosis and other forms of the disease: pathogenetic implications.
BACKGROUND
It has been suggested recently that deep endometriosis and the other forms of the disease do not share a common pathogenetic mechanism. In this study, we hypothesize that, if this is true, deep peritoneal endometriosis and the other forms should not be significantly associated.


METHODS
Clinical and surgical records of all women who were referred to the Department of Obstetrics and Gynecology, Clinica 'L.Mangiagalli' between January 1995 and June 2002 and who were diagnosed with deep peritoneal pelvic endometriosis at the time of surgery were retrieved. The concomitant presence of superficial endometriotic implants, endometriomas and pelvic adhesions was evaluated. A binomial probability distribution model was used to calculate the 95% confidence interval (95% CI) of the association rates.


RESULTS
Ninety-three women with deep peritoneal endometriosis were identified. The presence of superficial endometriotic implants, endometriomas and pelvic adhesions was documented in 61.3% (95% CI 51.4-71.2%), 50.5% (95% CI 40.3-60.7%) and 74.2% (95% CI 65.3-83.1%) of patients with deep endometriotic nodules, respectively. Overall, deep peritoneal endometriosis was the only form of the disease in only 6.5% (95% CI 2.8-12.3%) of cases. No relevant differences regarding these associations were observed according to the location and the size of the deep endometriotic nodules.


CONCLUSIONS
Results from this study do not support the hypothesis that deep endometriosis should be considered as a distinct entity of the disease.
Somigliana
Edgardo
E
II Department of Obstetrics and Gynecology, Clinica L.Mangiagalli, University of Milan, Milan, Italy. dadosomigliana@yahoo.it
Infantino
Mirco
M
Candiani
Massimo
M
Vignali
Michele
M
Chiodini
Annalisa
A
Busacca
Mauro
M
Vignali
Mario
M
D000291:Adnexal Diseases / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D016001:Confidence Intervals; D003560:Cysts / Q000453:epidemiology / Q000209:etiology; D004715:Endometriosis / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D010049:Ovarian Diseases / Q000453:epidemiology / Q000209:etiology; D010532:Peritoneal Diseases / Q000150:complications* / Q000473:pathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000267:Tissue Adhesions / Q000453:epidemiology / Q000209:etiology*