LPE a More Severe Manifestation of Endometriosis, Requiring Aggressive Tactics, Study Says

LPE a More Severe Manifestation of Endometriosis, Requiring Aggressive Tactics, Study Says

Lateral parametrial endometriosis (LPE) is a more severe manifestation of endometriosis and requires more aggressive surgery, according to researchers in Italy.

Their study, “Parametrial Endometriosis: the Occult Condition that Makes the Hard Harder,” was published in The Journal of Minimally Invasive Gynecology.

Deep infiltrating endometriosis (DIE) represents the most severe form of endometriosis and affects 20% of patients with the condition.

DIE is defined as the presence of endometrial tissue infiltration outside of the endometrium into organs that are near the uterus, including the bowel and the urinary bladder. DIE is the most invasive form of endometriosis as it is found deep within the tissue or organ.

DIE can sometimes involve the lateral parametrium, which is a band of fibrous tissue that separates the supravaginal (above the vagina) portion of the cervix from the bladder.

Even if physicians suspect that a patient has lateral parametrial endometriosis (LPE) during a clinical examination, the gold standard for diagnosis is to conduct a surgical dissection.

Despite the enormous impact of LPE, only a few studies have assessed its diagnosis, prevalence, and clinical features.

Researchers from S. Orsola Hospital, University of
Bologna in Italy, set out to estimate the intraoperative (during surgery) prevalence of LPE in patients affected by DIE and to analyze the clinical and surgical data associated with LPE.

Researchers investigated 1,360 women who were admitted for surgery of DIE between 2007 and 2017. Women were then divided into two groups according to the presence (231 patients) or absence (1,129 patients) of LPE.

Results indicated that the intraoperative prevalence of lateral parametrial endometriosis was 17%.

When looking at factors before the operation, women with LPE complained of having more severe dysmenorrhea (painful periods), more frequent voiding symptoms (a condition where there is poor coordination between the bladder muscle and the urethra), and more constipation.

During the surgery, researchers found that the presence of lateral parametrial endometriosis was associated with several factors, including the involvement of various vaginal areas.

During the operation, LPE patients tended to have a lump with a larger diameter.

The operation time and hospital stay were also longer for patients with LPE.

And, the lateral parametrial endometriosis group needed self-catheterization (a process which allows the patient’s urine to drain freely from the bladder for collection) more often than the control group at the time of discharge and at the one-month follow-up evaluation.

“LPE is an occult and not so rare condition and reflects a more severe manifestation of the disease, requiring more aggressive surgery,” the researchers wrote.

“Patients must be evaluated thoroughly and counselled properly during the preoperative examination, taking into account the significant morbidity, particularly regarding pelvic organ dysfunctions,” they added.


  1. mary says:

    Thank you for this information , i think my daughter has this , as she suffers with the bowl and the kidneys , and severe bacck pain , she had a colon today , but they said she would have to talk to her gyne about getting a special test dont for the bowl to see if the endo is go into it , is there a special test for the bowl for this endometriotis , she is in agony , would be grateful if you can reply ,as im very worried about her ,Doctors and the hospitals dont seem to care about the cronic pain she is in , every day without a break ,

    • Ember says:

      I understand what your daughter is going through. My OBGYN was able to do an out-patient procedure and found Endo on my intestines, bladder, kidneys, and liver. I also understand that the unknown for you and your daughter both can be scary and that at times it honestly feels like no one cares. I’ve had doctors treat me as though I were just looking for meds. Just remember to take a deep breath and take this one day at a time. Set an appt with her OBGYN and ask about options. If they are not familiar with endometriosis, find a specialist in your area. She will be okay. One of the hardest parts is finding help. Once you find her a good specialist you can start looking for answers and treatments. Good luck to you both!

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