Deep Infiltrating Endometriosis (DIE)

Definition - What does Deep Infiltrating Endometriosis (DIE) mean?

Deep infiltrating endometriosis (DIE) refers to the spread of endometrial deposits outside the uterine cavity into the lining of the pelvis or adjacent organs such as the bowel, bladder, ureter, vagina or other structures like the ligaments supporting the uterus. It can be considered as a severe form of endometriosis that leads to extensive scar tissue formation affecting the areas in or around the fallopian tubes that can lead to infertility.

FertilitySmarts explains Deep Infiltrating Endometriosis (DIE)

Deep infiltrating endometriosis occurs when large areas of endometriosis (called endometriomas) invade the wall of the ovaries, which begin to leak into the pelvis. The leaked contents will then stick to these areas, resulting in the formation of small rounded lumps and scars.

The symptoms of DIE resemble those of endometriosis with affected women experiencing:

  • Severe pelvic pain
  • Severe cramping during menstrual bleeding, with cramps worsening with the severity of the condition
  • Heavy vaginal bleeding
  • Bleeding between the periods
  • Pain during sex
  • Pain during the passage of stools
  • Pain during urination
  • Infertility

In women complaining of the above-listed signs and symptoms, a doctor will perform a transvaginal ultrasound to detect DIE implants in different locations. Women who do not plan for future child-bearing may be offered hormones and pain-control medications. The treatment of women who desire for future child-bearing does not, however, involve hormonal medications, as these do not have a positive impact on fertility.

The gold-standard method for the diagnosis and treatment of DIE is the direct visualization of the endometrial deposits via laparoscopy, preferably done in combination with the microscopic evaluation of the surgically removed abnormal sections.


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