Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis

Objective To investigate whether an associated ovarian endometrioma is a marker for severity of deep infiltrating endometriosis (DIE). Design Observational study between June 1992 and December 2005. Setting University tertiary referral center. Patient(s) Five hundred patients with histologically assessed DIE. Intervention(s) Complete surgical exeresis of deep endometriotic lesions. Main Outcome Measure(s) Severity of the disease was quantified according to the mean number of DIE lesions and the type of main lesion. Result(s) In patients with associated ovarian endometrioma, the number of single isolated DIE lesions was statistically significantly lower (41.9% vs. 61.1%). The mean number of DIE lesions was statistically significantly higher in patients presenting with an associated ovarian endometrioma (2.51 ± 1.72 vs. 1.64 ± 1.0). For patients with associated ovarian endometrioma DIE lesions were more severe with an increased rate of vaginal, intestinal, and ureteral lesions. Conclusion(s) Associated ovarian endometrioma is a marker for the severity of the DIE. In a clinical context suggestive of DIE, when there is an ovarian endometrioma, the practitioner should investigate the extent of the disease to check for severe and multifocal DIE lesions.