Clinical Prediction of Deeply Infiltrating Endometriosis before Surgery: Is It Feasible? A Review of the Literature

Table 1

Relationship between type of chronic pelvic pain (CPP) and deeply infiltrating endometriosis (DIE) lanatomic location.

Author	Type of study (𝑛)	Relationship between pain and DIE
Cornillie et al. (1990) [9]	Observational, prospective (𝑛 53)	Pelvic pain was strongly associated with deep lesions (>10 mm).
Koninckx et al. (1991) [10]	Observational, prospective (𝑛 643)	DIE was strongly associated with pelvic pain, and depth of the lesion was the main factor associated with pain.
Perper et al. (1995) [23]	Double blind observational, prospective (𝑛 70)	The intensity of menstrual pain is related to the number of endometrial implants in patients with endometriosis with either pelvic pain or infertility. No diagnosis of DIE.
Vercellini et al. (1996) [39]	Observational, prospective (𝑛 244)	Presence of vaginal lesions was associated frequently with severe deep dyspareunia. Stage was not related to pain symptoms.
Porpora et al. (1999) [24]	Observational, prospective (𝑛 90)	Deep endometriosis, pelvic adhesions, and ovarian cystic endometriosis were independent predictors of pelvic pain.; The severity of dysmenorrhea significantly correlated with the presence and extent of pelvic adhesions.; The severity of CPP pain correlated with DIE on the uterosacral ligaments and extent of pelvic adhesions. Deep dyspareunia correlated with DIE on the uterosacral ligaments.
Fauconnier et al. (2002) [11]	Obsevational, retrospective (𝑛 225)	The frequency of dyspareunia increased with a uterosacral ligament DIE location.; Noncyclic CPP pain was more frquent when DIE involved the bowel.; Gastrointestinal symptoms were associated with bowel or vaginal (dyschezia) DIE locations.; The frequency of severe dysmenorrhea increased with Douglas pouch adhesions.
Chapron et al. (2003) [26]	Observational, prospective/retrospective (𝑛 209)	The presence of a rectal or vaginal infiltration by the posterior DIE and extensiveness of adnexal adhesion were related to dysmenorrhea severity.
Chapron et al. (2005) [16]	Observational, prospective (𝑛 134)	The presence of a rectal or vaginal infiltration by the posterior DIE and extensiveness of adnexal adhesion were related to dysmenorrhea severity.
Vercellini et al. (2007) [22]	Observational, prospective (𝑛 1054)	A strong association was found between posterior cul-de-sac lesions and dyspareunia. The association between endometriosis stage and severity of pelvic symptoms was marginal and inconsistent and could be demonstrated only with a major increase in study power.
Seracchioli et al. (2008) [27]	Retrospective (𝑛 360)	Severity of dyschezia was significantly correlated with posterior DIE. A positive correlation occurred between severity of dyschezia and lesion diameter with rectovaginal endometriosis but not with anterior rectal wall involvement.