The tissue lining your uterus is called the endometrium. When this tissue grows outside of the uterine cavity, it becomes a condition known as endometriosis.
Deep infiltrating endometriosis is an advanced form of endometriosis. It occurs when the endometrial-like tissue has spread to organs in or near your pelvic cavity.
This condition is rare. It affects about 1 percent of women of reproductive age and 20 percent of those with endometriosis.
Read on to learn more about deep infiltrating endometriosis. This article will discuss the symptoms, diagnosis, and treatment of the condition.
Deep infiltrating endometriosis is an advanced type of endometriosis. It’s more severe and harder to treat than other forms.
Like general endometriosis, deep infiltrating endometriosis involves uterine-like tissue growth outside of the uterine cavity.
However, in general endometriosis, the tissue develops on the surface of other pelvic organs. In deep infiltrating endometriosis, it enters these organs by more than 5 millimeters deep.
This may include the:
There are no simple diagnostic tests to identify deep infiltrating endometriosis. This can make it difficult to diagnose the condition in a timely manner.
Doctors may use the following diagnostic tests:
- Medical history. A doctor will assess your overall health status and consider your risk for deep infiltrating endometriosis.
- Physical examination. During a physical exam, a doctor will check the organs in your pelvic area. They’ll look for signs of swelling and pain.
- Histological examination. In this test, a sample of your endometrial tissue is removed and examined under a microscope.
- Laparoscopy. In a laparoscopy, a doctor examines your reproductive organs using a thin tube connected to a camera. The tube is inserted through a small incision in your stomach and into your reproductive organs.
- Transvaginal ultrasound. A transvaginal ultrasound creates images of your reproductive organs. It involves a probe that is inserted into your vagina.
A doctor will likely use multiple tests to make a diagnosis.
The symptoms of deep infiltrating endometriosis are similar to general endometriosis but more severe.
This may include:
- severe pelvic pain
- painful urination (dysuria)
- painful menstruation (dysmenorrhea)
- genital pain before, during, or after sex (dyspareunia)
- digestive discomfort
Due to their severity, these symptoms can impact your quality of life.
If you’ve received a diagnosis of endometriosis, you may already be seeing a doctor and following a treatment plan. It’s important to not put off getting medical attention until your symptoms are very severe.
Remember, deep infiltrating endometriosis is an advanced form of the condition. If you already have endometriosis, it’s important to follow your treatment plan to reduce the risk of endometrial-like tissue entering your organs.
The exact cause of endometriosis is unknown.
Similarly, the cause of deep infiltrating endometriosis is still unclear. But there are some risk factors associated with the condition. Deep infiltrating endometriosis is
- are married
- are of an older age
- have siblings
- have been pregnant
- have had previous uterine surgery
- have had menstrual and ovulatory disorders
- have painful intercourse with deep vaginal penetration (deep dyspareunia)
- have high levels of stress
- have digestive symptoms during periods
- have a family history of endometriosis
- use oral contraceptives
If you’re concerned about your risk, talk with a doctor.
There’s no cure for endometriosis. However, there are treatments that can reduce the amount of endometrial tissue entering pelvic organs and offer relief.
Medication options include:
- pain relievers
- oral contraceptives
- progestogens
- gonadotropin-releasing hormone analogs
Surgical treatments may include:
- laparoscopic surgery
- laser ablation
- removal of affected organs
You’ll likely need a combination of treatments. The best option for you depends on your symptoms.
When left untreated, deep infiltrating endometriosis can cause rare but serious complications:
Frozen pelvis
As endometrial tissue enters pelvic organs, it can fuse the organs together. This can cause a condition known as frozen pelvis, in which the organs are stuck together and “frozen” in place.
Frozen pelvis is difficult to treat. It can increase the risk for complications, especially if surgery is required.
Spontaneous hemoperitoneum
In spontaneous hemoperitoneum, there is blood in the peritoneal cavity unrelated to trauma.
The peritoneal cavity is the space in your abdomen that contains your:
- intestines
- stomach
- liver
One cause of spontaneous hemoperitoneum is a ruptured endometrioma, or “chocolate cyst.” An endometrioma occurs when endometrial tissue grows on the ovaries and forms cysts. If an endometrioma bursts, it can cause bleeding in the peritoneal cavity.
Another cause is a utero-ovarian vessel hemorrhage. This occurs when a blood vessel between the uterus and ovaries bursts, resulting in spontaneous hemoperitoneum.
This complication of deep infiltrating endometriosis is a life threatening complication.
Deep infiltrating endometriosis is a severe form of endometriosis. It occurs when endometrial-like tissue grows deep within your pelvic organs. This can cause severe pelvic pain, as well as pain during urination, sex, and menstrual periods.
It’s unclear what causes deep infiltrating endometriosis. Possible risk factors include having menstrual or ovulatory disorders, high stress levels, and prior pregnancies.
If you have endometriosis, it’s important to visit a doctor regularly and to follow your treatment plan. This can help reduce your risk of deep infiltrating endometriosis and its complications.